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Tran AT, Rizk E, Haas EM, et al. Real-World Data on Liposomal Bupivacaine and Inpatient Hospital Costs After Colorectal Surgery. J Surg Res. 2022;272:175-183doi: 10.1016/j.jss.2021.12.002.
Tran, A. T., Rizk, E., Haas, E. M., Naufal, G., Zhong, L., & Swan, J. T. (2022). Real-World Data on Liposomal Bupivacaine and Inpatient Hospital Costs After Colorectal Surgery. The Journal of surgical research, 272175-183. https://doi.org/10.1016/j.jss.2021.12.002
Tran, Anh Thu, et al. "Real-World Data on Liposomal Bupivacaine and Inpatient Hospital Costs After Colorectal Surgery." The Journal of surgical research vol. 272 (2022): 175-183. doi: https://doi.org/10.1016/j.jss.2021.12.002
Tran AT, Rizk E, Haas EM, Naufal G, Zhong L, Swan JT. Real-World Data on Liposomal Bupivacaine and Inpatient Hospital Costs After Colorectal Surgery. J Surg Res. 2022 Jan 06;272:175-183. doi: 10.1016/j.jss.2021.12.002. Epub 2022 Jan 06. PMID: 34999518.
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J Surg Res. 2022 Jan 06;272:175-183. doi: 10.1016/j.jss.2021.12.002. Epub 2022 Jan 06.

Real-World Data on Liposomal Bupivacaine and Inpatient Hospital Costs After Colorectal Surgery.

The Journal of surgical research

Anh Thu Tran, Elsie Rizk, Eric M Haas, George Naufal, Lixian Zhong, Joshua T Swan

Affiliations

  1. Departments of Pharmacy and Surgery, Houston Methodist, Houston, Texas.
  2. Department of Surgery, Baylor College of Medicine, Houston, Texas; Division of Colon and Rectal Surgery, Houston Methodist Hospital, Houston, Texas.
  3. Public Policy Research Institute, Texas A&M University, College Station, Texas; Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas.
  4. Department of Pharmaceutical Sciences, Texas A&M University, College Station, Texas.
  5. Departments of Pharmacy and Surgery, Houston Methodist, Houston, Texas; Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas. Electronic address: [email protected].

PMID: 34999518 DOI: 10.1016/j.jss.2021.12.002

Abstract

INTRODUCTION: This study compared costs of care among colorectal surgery patients who received liposomal bupivacaine versus those who did not (control) from a health institution perspective.

MATERIAL AND METHODS: This pharmacoeconomic evaluation was conducted among adults undergoing open or minimally invasive colorectal resection at an academic medical center from May 2016 to February 2018. Healthcare resource utilization was derived from the electronic health record. Total cost of care (2018 USD) was analyzed using a generalized linear model adjusted for American Society of Anesthesiologists score, enhanced recovery after surgery management, open surgery, opioid use before surgery, height, cancer, and age. The primary analysis used public costs. A sensitivity analysis used internal costs from the hospital to maximize internal validity.

RESULTS: Of 486 included patients, 286 (59%) received liposomal bupivacaine. Total cost of care using public costs included perioperative local anesthetics (mean ± standard deviation [SD]: $392 ± 74 liposomal bupivacaine versus $8 ± 13 control), analgesics within 48 h after surgery (mean ± SD: $132 ± 99 liposomal bupivacaine versus $117 ± 127 control), postoperative ileus management (mean ± SD: $5 ± 51 liposomal bupivacaine versus $65 ± 284 control), and hospital length of stay (mean ± SD: $4459 ± 3576 liposomal bupivacaine versus $7769 ± 7082 control). Liposomal bupivacaine was associated with an adjusted absolute difference in total cost of care of -$1435 (95% confidence interval -$2401 to -$470; P = 0.004) using public costs and -$1345 (95% confidence interval -$2215 to -$476; P = 0.002) using internal costs.

CONCLUSIONS: Use of liposomal bupivacaine in colorectal surgery was associated with a significant reduction in total cost of care that was predominately driven by reduced costs for hospital stay and postoperative ileus management despite higher medication costs.

Copyright © 2021 Elsevier Inc. All rights reserved.

Keywords: Colorectal surgery; Hospital cost; Liposomal bupivacaine; Local anesthetic; Opioid; Pain management

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