Economic analysis of alvimopan in North American Phase III efficacy trials

Timothy J. Bell, Sara A. Poston, Michael D. Kraft, Anthony J. Senagore, Conor P. Delaney, Lee Techner

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Purpose. The economic effect of the use of alvimopan in four randomized, double-blind, placebo-controlled, Phase III, North American efficacy trials was analyzed. Methods. Patients were eligible for the study if they were 18 years or older, were undergoing laparotomy for partial small or large bowel resection with primary anastomosis, and were scheduled for postoperative pain management with opioid-based i.v. patient-controlled analgesia. Patients analyzed in the North American Phase III trials received placebo or alvimopan 12 mg orally before surgery. Doses were administered twice daily beginning the day after surgery until hospital discharge or for a maximum of 15 doses. Results. Compared with placebo, alvimopan was associated with a significantly shorter mean time to gastrointestinal (GI) recovery and a significantly shorter mean time to a written discharge order. Alvimopan was also associated with a mean hospital length of stay (LOS) of one full day less than placebo. The mean cost of alvimopan based on a mean of 8.9 12-mg doses was $558.00; the alvimopan cost at the upper limit of allowed dosing was $937.50. Combining the alvimopan and hospital costs for each patient, total costs for the alvimopan group were estimated to be lower than for the placebo group. Conclusion. In a post hoc analysis, alvimopan was associated with significantly faster upper and lower GI recovery after bowel resection and a mean LOS reduction of one day compared with placebo. The mean estimated hospital cost was $879- $977 less for patients who received alvimopan compared with placebo. The base-case and sensitivity analyses suggest that, on average, the use of alvimopan compared with placebo may have a cost-saving effect in the hospital setting.

Original languageEnglish (US)
Pages (from-to)1362-1368
Number of pages7
JournalAmerican Journal of Health-System Pharmacy
Volume66
Issue number15
DOIs
StatePublished - Aug 1 2009
Externally publishedYes

Fingerprint

alvimopan
Economics
Placebos
Costs and Cost Analysis
Length of Stay
Hospital Costs
Patient-Controlled Analgesia

Keywords

  • Alvimopan
  • Costs
  • Hospitals
  • Ileus
  • Opiate antagonists
  • Opiates
  • Pain
  • Pharmacoeconomics
  • Postoperative complications
  • Toxicity

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy

Cite this

Bell, T. J., Poston, S. A., Kraft, M. D., Senagore, A. J., Delaney, C. P., & Techner, L. (2009). Economic analysis of alvimopan in North American Phase III efficacy trials. American Journal of Health-System Pharmacy, 66(15), 1362-1368. https://doi.org/10.2146/ajhp080329

Economic analysis of alvimopan in North American Phase III efficacy trials. / Bell, Timothy J.; Poston, Sara A.; Kraft, Michael D.; Senagore, Anthony J.; Delaney, Conor P.; Techner, Lee.

In: American Journal of Health-System Pharmacy, Vol. 66, No. 15, 01.08.2009, p. 1362-1368.

Research output: Contribution to journalArticle

Bell, TJ, Poston, SA, Kraft, MD, Senagore, AJ, Delaney, CP & Techner, L 2009, 'Economic analysis of alvimopan in North American Phase III efficacy trials', American Journal of Health-System Pharmacy, vol. 66, no. 15, pp. 1362-1368. https://doi.org/10.2146/ajhp080329
Bell, Timothy J. ; Poston, Sara A. ; Kraft, Michael D. ; Senagore, Anthony J. ; Delaney, Conor P. ; Techner, Lee. / Economic analysis of alvimopan in North American Phase III efficacy trials. In: American Journal of Health-System Pharmacy. 2009 ; Vol. 66, No. 15. pp. 1362-1368.
@article{f4d8168e3b0b46e3ab67641c528735b6,
title = "Economic analysis of alvimopan in North American Phase III efficacy trials",
abstract = "Purpose. The economic effect of the use of alvimopan in four randomized, double-blind, placebo-controlled, Phase III, North American efficacy trials was analyzed. Methods. Patients were eligible for the study if they were 18 years or older, were undergoing laparotomy for partial small or large bowel resection with primary anastomosis, and were scheduled for postoperative pain management with opioid-based i.v. patient-controlled analgesia. Patients analyzed in the North American Phase III trials received placebo or alvimopan 12 mg orally before surgery. Doses were administered twice daily beginning the day after surgery until hospital discharge or for a maximum of 15 doses. Results. Compared with placebo, alvimopan was associated with a significantly shorter mean time to gastrointestinal (GI) recovery and a significantly shorter mean time to a written discharge order. Alvimopan was also associated with a mean hospital length of stay (LOS) of one full day less than placebo. The mean cost of alvimopan based on a mean of 8.9 12-mg doses was $558.00; the alvimopan cost at the upper limit of allowed dosing was $937.50. Combining the alvimopan and hospital costs for each patient, total costs for the alvimopan group were estimated to be lower than for the placebo group. Conclusion. In a post hoc analysis, alvimopan was associated with significantly faster upper and lower GI recovery after bowel resection and a mean LOS reduction of one day compared with placebo. The mean estimated hospital cost was $879- $977 less for patients who received alvimopan compared with placebo. The base-case and sensitivity analyses suggest that, on average, the use of alvimopan compared with placebo may have a cost-saving effect in the hospital setting.",
keywords = "Alvimopan, Costs, Hospitals, Ileus, Opiate antagonists, Opiates, Pain, Pharmacoeconomics, Postoperative complications, Toxicity",
author = "Bell, {Timothy J.} and Poston, {Sara A.} and Kraft, {Michael D.} and Senagore, {Anthony J.} and Delaney, {Conor P.} and Lee Techner",
year = "2009",
month = "8",
day = "1",
doi = "10.2146/ajhp080329",
language = "English (US)",
volume = "66",
pages = "1362--1368",
journal = "American Journal of Health-System Pharmacy",
issn = "1079-2082",
publisher = "American Society of Health-Systems Pharmacy",
number = "15",

}

TY - JOUR

T1 - Economic analysis of alvimopan in North American Phase III efficacy trials

AU - Bell, Timothy J.

AU - Poston, Sara A.

AU - Kraft, Michael D.

AU - Senagore, Anthony J.

AU - Delaney, Conor P.

AU - Techner, Lee

PY - 2009/8/1

Y1 - 2009/8/1

N2 - Purpose. The economic effect of the use of alvimopan in four randomized, double-blind, placebo-controlled, Phase III, North American efficacy trials was analyzed. Methods. Patients were eligible for the study if they were 18 years or older, were undergoing laparotomy for partial small or large bowel resection with primary anastomosis, and were scheduled for postoperative pain management with opioid-based i.v. patient-controlled analgesia. Patients analyzed in the North American Phase III trials received placebo or alvimopan 12 mg orally before surgery. Doses were administered twice daily beginning the day after surgery until hospital discharge or for a maximum of 15 doses. Results. Compared with placebo, alvimopan was associated with a significantly shorter mean time to gastrointestinal (GI) recovery and a significantly shorter mean time to a written discharge order. Alvimopan was also associated with a mean hospital length of stay (LOS) of one full day less than placebo. The mean cost of alvimopan based on a mean of 8.9 12-mg doses was $558.00; the alvimopan cost at the upper limit of allowed dosing was $937.50. Combining the alvimopan and hospital costs for each patient, total costs for the alvimopan group were estimated to be lower than for the placebo group. Conclusion. In a post hoc analysis, alvimopan was associated with significantly faster upper and lower GI recovery after bowel resection and a mean LOS reduction of one day compared with placebo. The mean estimated hospital cost was $879- $977 less for patients who received alvimopan compared with placebo. The base-case and sensitivity analyses suggest that, on average, the use of alvimopan compared with placebo may have a cost-saving effect in the hospital setting.

AB - Purpose. The economic effect of the use of alvimopan in four randomized, double-blind, placebo-controlled, Phase III, North American efficacy trials was analyzed. Methods. Patients were eligible for the study if they were 18 years or older, were undergoing laparotomy for partial small or large bowel resection with primary anastomosis, and were scheduled for postoperative pain management with opioid-based i.v. patient-controlled analgesia. Patients analyzed in the North American Phase III trials received placebo or alvimopan 12 mg orally before surgery. Doses were administered twice daily beginning the day after surgery until hospital discharge or for a maximum of 15 doses. Results. Compared with placebo, alvimopan was associated with a significantly shorter mean time to gastrointestinal (GI) recovery and a significantly shorter mean time to a written discharge order. Alvimopan was also associated with a mean hospital length of stay (LOS) of one full day less than placebo. The mean cost of alvimopan based on a mean of 8.9 12-mg doses was $558.00; the alvimopan cost at the upper limit of allowed dosing was $937.50. Combining the alvimopan and hospital costs for each patient, total costs for the alvimopan group were estimated to be lower than for the placebo group. Conclusion. In a post hoc analysis, alvimopan was associated with significantly faster upper and lower GI recovery after bowel resection and a mean LOS reduction of one day compared with placebo. The mean estimated hospital cost was $879- $977 less for patients who received alvimopan compared with placebo. The base-case and sensitivity analyses suggest that, on average, the use of alvimopan compared with placebo may have a cost-saving effect in the hospital setting.

KW - Alvimopan

KW - Costs

KW - Hospitals

KW - Ileus

KW - Opiate antagonists

KW - Opiates

KW - Pain

KW - Pharmacoeconomics

KW - Postoperative complications

KW - Toxicity

UR - http://www.scopus.com/inward/record.url?scp=67650913534&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67650913534&partnerID=8YFLogxK

U2 - 10.2146/ajhp080329

DO - 10.2146/ajhp080329

M3 - Article

C2 - 19635772

AN - SCOPUS:67650913534

VL - 66

SP - 1362

EP - 1368

JO - American Journal of Health-System Pharmacy

JF - American Journal of Health-System Pharmacy

SN - 1079-2082

IS - 15

ER -