Buprenorphine: a cost-effective alternative to Schedule II analgesics for moderate to severe pain relief

A retrospective study was undertaken at Morristown Memorial Hospital to evaluate the cost impact of buprenorphine HCl, a Schedule V injectable analgesic, versus the Schedule II drugs morphine and meperidine HCl. Time-and-motion studies were conducted in the pharmacy and nursing units. Algorithms were used to determine the cost of auditing, ordering, dispensing, recording, and administering a single dose of Schedule II and Schedule V injectable analgesics. Based on acquisition costs and duration of analgesia, total 24-hour dose costs were calculated for buprenorphine, morphine, and meperidine. The resultant cost comparisons demonstrated that the use of buprenorphine as an alternative to morphine and meperidine for moderate to severe postoperative pain is highly cost-effective and, in this hospital, resulted in a total cost avoidance of up to 67% of analgesic cost per patient per day.