Alvimopan Use, Outcomes, and Costs: A Report from the Surgical Care and Outcomes Assessment Program Comparative...

Area of Science:

• Colorectal surgery outcomes
• Pharmacoeconomics
• Health services research

Background:

• Randomized trials indicate alvimopan accelerates bowel function return and reduces length of stay (LOS) by 1 day post-colorectal surgery.
• The effectiveness of alvimopan in real-world clinical settings and its effect on hospital expenses remain under investigation.

Purpose of the Study:

• To evaluate the effectiveness of alvimopan in routine clinical practice for patients undergoing colorectal surgery.
• To assess the impact of alvimopan on hospital length of stay (LOS) and associated costs.

Main Methods:

• Retrospective cohort study of 14,781 patients undergoing elective colorectal surgery in Washington state (2009-2013).
• Data linked from a clinical registry and statewide hospital discharge database.
• Generalized estimating equations used to analyze alvimopan's association with outcomes, adjusting for patient, operative, and management factors. Hospital charges converted to costs and adjusted for inflation.

Main Results:

• 11% of patients (1,615) received alvimopan.
• Alvimopan recipients had a 1.8-day shorter LOS and $2,017 lower costs compared to non-recipients.
• Adjusted analysis showed alvimopan associated with a 0.9-day shorter LOS and $636 lower hospital costs.

Conclusions:

• Alvimopan use in routine practice is linked to reduced LOS and significant hospital cost savings.
• Efficacy and effectiveness data support alvimopan's use in clinical practice.
• Alvimopan utilization may serve as an indicator of enhanced quality of care.