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首页> 外文期刊>P & T: a peer-reviewed journal for formulary management >Impact of alvimopan (entereg) on hospital costs after bowel resection: results from a large inpatient database.
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Impact of alvimopan (entereg) on hospital costs after bowel resection: results from a large inpatient database.

机译：肠切除术后alvimopan（entereg）对医院费用的影响：来自大型住院数据库的结果。

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PURPOSE: Delayed gastrointestinal (GI) recovery after bowel resection is associated with longer hospital stays and increased health care costs. Alvimopan (Entereg), a peripherally acting mu-opioid receptor antagonist, accelerates GI recovery after bowel-resection surgery. We undertook a study to evaluate the economic impact of alvimopan in clinical practice. METHODS: We conducted a retrospective matched cohort study using data from a large national hospital database and identified adults who had undergone small-bowel or large-bowel resection with primary anastomosis. The patients were discharged between January 1, 2009, and June 30, 2009. The surgery was performed at a hospital where alvimopan was used at least once during the study period. We matched each alvimopan patient ("user") with two controls ("non-users"). The primary outcome of total hospital costs (including the cost of alvimopan) and secondary outcomes of cost components and length of stay were compared between groups. RESULTS: The final study cohort included 480 alvimopan patients and 960 matched controls. The mean total hospital cost was Dollars 12,865 for alvimopan patients, compared with Dollars 13,905 for controls, for a difference of Dollars 1,040 (P = 0.033). There was a non-significant trend toward lower ileus-related costs between groups (Dollars 83 for alvimopan vs. Dollars 114 for controls, P = 0.086). Pharmacy and diagnostic radiology costs did not differ significantly. The mean length of stay was 5.6 days for alvimopan patients and 6.5 days for controls (P < 0.001). CONCLUSION: Patients receiving alvimopan capsules had significantly lower total hospital costs compared with controls. Along with other initiatives to improve quality and reduce costs of surgical care, alvimopan might be a good choice for use in the perioperative management of patients who undergo segmental bowel resection with primary anastomosis.
机译：目的：肠切除术后胃肠道（GI）恢复延迟与住院时间延长和医疗保健费用增加有关。 Alvimopan（Entereg）是一种外围作用的类阿片受体拮抗剂，可在肠切除术后加速胃肠道的恢复。我们进行了一项研究，以评估alvimopan在临床实践中的经济影响。方法：我们使用来自大型国立医院数据库的数据进行了一项回顾性配对队列研究，确定了接受原发性吻合术的小肠或大肠切除术的成年人。患者于2009年1月1日至2009年6月30日之间出院。在研究期间，在至少使用alvimopan的医院进行了手术。我们将每个阿尔维莫潘患者（“用户”）与两个控件（“非用户”）进行匹配。比较两组间总医院费用（包括阿尔维莫潘的费用）的主要结果以及费用构成和住院时间的次要结果。结果：最后的研究队列包括480名阿尔维莫潘患者和960名相匹配的对照组。 alvimopan患者的平均总住院费用为12,865美元，而对照组为13,905美元，相差1,040美元（P = 0.033）。组间回肠相关费用降低的趋势不明显（阿尔维莫潘组为83美元，对照组为114美元，P = 0.086）。药房和放射诊断费用没有显着差异。 alvimopan患者的平均住院时间为5.6天，对照组为6.5天（P <0.001）。结论：与对照组相比，接受阿尔莫潘胶囊的患者的总住院费用明显降低。除提高质量和降低手术治疗成本的其他举措外，alvimopan可能是用于行部分肠切除术并原发性吻合的患者围手术期管理的好选择。

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