Intravenous (IV) Admnistration of Morphine For Moderate-To-Severe Acute Pain In The Emergency Room (ER) Setting Inflicts A Substantial Economic Burden In The EU5

DiDonato, Karen; Palmer, P.; Morris, T.M.; Walker, Judith A.; Casamayor, Montserrat; Hennebert, Marc

doi:10.1016/j.jval.2016.09.1360

Cited by 1 publication

(5 citation statements)

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“…The authors of the current paper have evaluated costs of treating moderate-to-severe pain in the ED in 5 European countries: France, Germany, Italy, Spain, and the United Kingdom. 19 Since there is no EU-based database similar to Premier's database from which to analyze data, a micro-costing approach was taken to estimate costs. This EU study revealed total estimated costs of €121-€132 ($138-$150) to manage an episode of acute pain.…”

Section: Discussionmentioning

confidence: 99%

“…The primary analysis did not include the cost of management of key adverse events (AEs) and IV complications associated with IV administration of opioids; however these have been considered in previous publications 19 and are estimated from the literature for the US population to provide a broader assessment of true costs. Table 3 indicates that a total of 7 327 299 encounters occurred during the 24-month time frame of which 3 055 611 (41.7%) led to inpatient admission.…”

Section: Methodsmentioning

confidence: 99%

“…We have estimated these, based on literature review which has been, in part, previously reported. 19 As displayed in Table 6, Table 7, and Table 8, costs for the management of the most common AEs and IV complications were estimated at $118 for morphine, $119 for hydromorphone, and $118 for fentanyl.…”

Section: Opioid Administration Costsmentioning

confidence: 99%

“…Therefore, adding the costs of management of AEs and IV complications leads to considerable costs, ranging from $269 to $273. 19 except for the treatment of nausea and vomiting in which ondansetron was substituted for metoclopramide to reflect the more common use of this agent in the United States. AE: adverse event; IV: intravenous; ED: emergency department Costs were derived from the product of the rates for each drug (Table 6) and the cost of management of each event (Table 7).…”

Section: Opioid Administration Costsmentioning

confidence: 99%

“…Very few studies have assessed actual resource utilization and costs associated with IV administration of opioids in the United States 16,17 or indeed elsewhere (one study has been conducted in Hong Kong 18 and one had a European focus 19 ).…”

mentioning

confidence: 99%

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Cost of Intravenous Analgesia for the Management of Acute Pain in the Emergency Department is Substantial in the United States

Palmer

Walker

Patanwala

et al. 2017

JHEOR

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Background: Pain is a leading cause of admission to the emergency department (ED) and moderate-to-severe acute pain in medically supervised settings is often treated with intravenous (IV) opioids. With novel noninvasive analgesic products in development for this indication, it is important to assess the costs associated with IV administration of opioids. Materials and Methods: A retrospective observational study of data derived from the Premier database was conducted. All ED encounters of adult patients treated with IV opioids during a 2-year time period, who were charged for at least one IV opioid administration in the ED were included. Hospital reported costs were used to estimate the costs to administer IV opioids. Results: Over a 24 month-period, 7.3 million encounters, which included the administration of IV opioids took place in 614 US EDs. The mean cost per encounter of IV administration of an initial dose of the three most frequently prescribed opioids were: morphine $145, hydromorphone $146, and fentanyl $147. The main driver of the total costs is the cost of nursing time and equipment cost to set up and maintain an IV infusion ($140 ± 60). Adding a second dose of opioid, brings the average costs to $151-$154. If costs associated with the management of opioid-related adverse events and IV-related complications are also added, the total costs can amount to $269-$273. Of these 7.3 million encounters, 4.3 million (58%) did not lead to hospital admission of the patient and, therefore, the patient may have only required an IV catheter for opioid administration. Conclusions: IV opioid use in the ED is indicated for moderate-to-severe pain but is associated with significant costs. In subjects who are discharged from the ED and may not have required an IV for reasons other than opioid administration, rapid-onset analgesics for moderate-to-severe pain that do not require IV administration could lead to direct cost reductions and improved care.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Opioid Administration Costsmentioning

confidence: 99%

Section: Opioid Administration Costsmentioning

confidence: 99%

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confidence: 99%

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