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October 14, 2010

Use of an anti-vomiting drug for stomach flu patients could save millions of dollars

TORONTO – Stomach flu or gastroenteritis, a common illness in children, can be unpleasant to say the least. Not only do patients experience diarrhea and vomiting, but in cases where children become very dehydrated, they could require intravenous treatment and even hospitalization, causing additional pain for patients and stress for parents.  Recent studies suggest the use of an anti-vomiting drug called ondansetron reduces the frequency of vomiting, the need for intravenous rehydration and maybe even hospitalization. A study led by The Hospital for Sick Children (SickKids) published this month in PLoS Medicine shows that there is also a big economic benefit to using the drug.

Researchers found that in Canada, the proper use of ondansetron would prevent approximately 4,000 intravenous insertions and more than 1,000 hospitalizations annually. Its routine administration would save Canadian society an average of $1.72 million dollars, including an average of $1.18 million dollars for the health-care system. Societal savings includes both the direct savings to the health-care system as well as the indirect savings in terms of productivity, which is reflected by parents missing work, having to spend extra money on child care and over-the-counter medications.

“This study is the first to demonstrate that in addition to being clinically beneficial, the administration of oral ondansetron is economically advantageous,” says the study’s lead author, Dr. Stephen Freedman, Physician in the SickKids Departments of Paediatric Emergency Medicine and Gastroenterology, Hepatology and Nutrition, Associate Scientist at SickKids and Assistant Professor of Paediatrics at the University of Toronto.

Working in collaboration with Dr. Michael Steiner, Assistant Professor of Paediatrics at the University of North Carolina School of Medicine, the research team found that the economic advantage is even more evident in the United States. The study shows that with appropriate use, ondansetron administration would save society annually US$65.6 million, including savings of US$61.1 million for health-care payers, while preventing more than 29,000 intravenous insertions in children and more than 7,000 hospitalizations.

In Canada, it’s estimated that every year more than 239,000 children seek emergency department care because of the stomach flu, and in 10 to 20 per cent of cases presenting for emergency department care, ondansetron administration would be appropriate. Previous studies have shown ondansetron to be beneficial when given to children with mild to moderate dehydration accompanied by frequent vomiting. However, Freedman points out that mainly because of economic concerns, many institutions have not incorporated the drug into their clinical practice pattern.

“Based on the clinical and economic benefits, the use of ondansetron should become routine in the treatment of children with gastroenteritis, vomiting, and evidence of dehydration.  This is based on evidence that if used appropriately in North American emergency departments, it will reduce both the burden of disease on children and the costs to society and health-care systems,” says Freedman.

The study is supported by SickKids Foundation.

About The Hospital for Sick Children
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally.  Its mission is to provide the best in complex and specialized child and family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision for Healthier Children. A Better World. For more information, please visit www.sickkids.ca. Follow us on Twitter (@SickKidsNews) and Instagram (@SickKidsToronto).

For more information, please contact:

Matet Nebres
The Hospital for Sick Children
Phone: 416-813-6380
email: matet.nebres@sickkids.ca

Suzanne Gold
The Hospital for Sick Children
Phone: 416-813-7654 ext. 2059
email: suzanne.gold@sickkids.ca