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DIFFERENCES IN CLINICAL OUTCOMES AND COSTS ASSOCIATED WITH THE USE OF STAPLE LINE BUTTRESS IN BARIATRIC SURGERY
A246
VA L U E I N H E A LT H 1 9 ( 2 0 1 6 ) A 1 - A 3 1 8
PSY28 HOSPITALIZATIONS FOR OLDER PATIENTS WITH ACUTE MYELOID LEUKEMIA: INPATIENT TREATMENT IS INTENSIVE AND COSTLY Sacks N 1, Cyr P 1, Noone J 1, Miller D 2, Louie A 2 for Value, Boston, MA, USA, 2Celator Pharmaceuticals, Inc., Ewing, NJ, USA .
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1Precision
Objectives: Acute Myeloid Leukemia (AML) disproportionately affects older patients. Treatment often requires lengthy hospitalizations, including those for chemotherapy administration and follow-up. Recent studies suggest that outpatient management following chemotherapy may be safe and reduce costs, but information on the characteristics of AML hospitalizations is limited. The objective of this study is to characterize costs and length of stay (LOS) for hospitalizations in the US for older adults with AML. Methods: We used the 2013 Medicare Inpatient Limited Data Set (LDS) file to identify hospitalizations with a principal or secondary diagnosis of AML (ICD-9 205.0). We grouped hospitalizations by the Diagnosis Related Group (DRG) used for reimbursement and calculated mean payments and LOS by DRG. We identified hospitalizations where chemotherapy was administered using ICD9 procedure codes V58.1 and 99.25. Results: Of 12,524 hospitalizations with AML as a discharge diagnosis, AML was the principal diagnosis for 6,655 (53.1%). Mean payment for these hospitalizations was $37,198; average LOS was 13.6 days. These hospitalizations included 2,219 ICU stays with mean ICU LOS of 9.6 days. Nearly all principal AML diagnosis hospitalizations (6,563) were assigned to one of four DRGs, with payments and LOS ranging from $10,111/4.8d to $97,797/25.5d; the ICU LOS range was from 4.6d to 21.8d. Chemotherapy was administered in a subset of all AML hospitalizations (N= 3,646; 29.1%), including 2,190 where AML was principal diagnosis. For hospitalizations where chemotherapy was the principal and AML a secondary diagnosis (N= 1,357), mean payments and LOS ranged from $9,339/6.1d to $48,597/24.7d. Patients were in the ICU in only 12.6% of these hospitalizations. Conclusions: Treatment intensity and costs are high for AML patients receiving and not receiving chemotherapy. Many hospitalizations where chemotherapy is administered do not involve ICU stays, suggesting that outpatient management following chemotherapy could be safe for some patients and reduce patient burden and hospital/payer costs. PSY29 INCREMENTAL HEALTH CARE EXPENDITURES ASSOCIATED WITH DEPRESSION AMONG INDIVIDUALS WITH CUTANEOUS LUPUS ERYTHEMATOSUS Ogunsanya M , Nduaguba S O , Brown C The University of Texas at Austin, Austin, TX, USA .
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Objectives: To estimate the incremental healthcare expenditures and utilization associated with depression among adults with CLE. Methods: Using the 2013 Medical Expenditure Panel Survey (MEPS), CLE patients with and without depression were compared to determine differences in: a) healthcare utilization – inpatient, outpatient, office and emergency room (ER) visits, and prescriptions filled; and b) expenditures – total costs, inpatient, outpatient, office-based, ER, and prescription medication costs, and other costs using demographically and comorbidity adjusted multivariate models (age, gender, race/ethnicity, marital status, poverty category, smoking status, and Charlson comorbidity index). Results: Adults with CLE and depression had more inpatient visits (0.50 vs. 0.29, p< 0.001), outpatient visits (2.05 vs. 1.15, p< 0.05), office-based visits (22.09 v 16.50, p< 0.001), ER visits (0.57 vs. 0.24, p< 0.001), and prescriptions filled (53.62 vs. 23.74, p< 0.001) than those without depression. They also had higher average annual total expenditures ($18,824 vs. $10,058). Thus, the annual total incremental medical expenditure associated with depression was estimated as $8,766(SE: $4,215; p < 0.001) per person. Officebased visit cost, estimated at $2,171 (SE: $1,365; p< 0.001) accounted for the largest proportion of the overall incremental expenditures, followed by inpatient cost at $2,780 (SE: $2,009; p< 0.05). Together, they accounted for approximately 56.4% of the total incremental cost. After adjustment, adults with CLE and depression spent 57% more on annual total healthcare expenditures than those without depression (RR = 1.57, 95% CI [0.11, 1.93]). Likewise, cost of inpatient (RR = 1.27, 95% CI [1.04, 2.59]), and prescription drugs (RR = 1.40, 95% CI [1.29, 1.68]) were associated with depression. Conclusions: Among adults with CLE, depression was associated with higher healthcare expenditures. Early diagnosis and treatment of depression in CLE patients may reduce total expenditures and utilization in this population. PSY30 DIFFERENCES IN CLINICAL OUTCOMES AND COSTS ASSOCIATED WITH THE USE OF STAPLE LINE BUTTRESS IN BARIATRIC SURGERY Ghosh S K 1, Ryan M P 2, Gache L M 2, Roy S 3, Fegelman E 4 Health Economics and Market Access, Ethicon, Inc., Cincinnati, OH, USA, 2CTI Clinical Trial and Consulting Services, Cincinnati, OH, USA, 3Johnson and Johnson Global Surgery, Somerville, NJ, USA, 4Johnson & Johnson (Ethicon), Cincinnati, OH, USA .
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1Global
Objectives: Buttress material, either absorbable or permanent, is widely used in bariatric surgery. The aim of this research was to assess differences in clinical and economic outcomes associated with the use of staple line buttress in inpatient Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) surgical procedures. Methods: Data from the Premier Perspective DatabaseTM from January 2006 to March 2014 were analyzed. Adult patients undergoing single primary SG or RYGB procedures were identified using ICD-9 codes. A keyword-based algorithm was used to identify buttress use. Assessed outcomes variables were length of stay (LOS), 30-day readmission rate, occurrence of significant bleeding (≥ 3units of transfusion blood product) and total cost to hospital. Differences between the buttress and non-buttress groups were evaluated using multivariate regression models for readmissions, LOS and total cost. Input variables for the regression models were buttress use, surgical characteristics, patient characteristics, patient comorbidities and hospital characteristics. Results: 79,041 RYGB (21,157 buttress and 57,884 non-buttress) and 28,850 SG (9,588 buttress and 19,262 non-buttress) patients were included in the analysis. Observed outcomes were slightly favorable for the buttress group: LOS (SG: 1.9±1.3 days vs. 2.1±2.8 days; RYGB: 2.4±2.7 days vs. 3.7±7.1 days),
30-day readmission (SG: 4.1% vs. 4.7%; RYGB: 7.1% vs. 8.5%) and significant blood loss (SG: 0.1% vs. 0.4%; RYGB: 0.5% vs. 1.4%). Total hospital cost was higher for the SG buttress group (SG: $11,893±7,751 vs. $11,239±9,874) and lower for RYGB buttress ($13,984±10,857 vs. $14,801±15,846). Multivariable regression analysis showed statistically significant (p< 0.05) differences in favor of the buttress group for LOS in RYGB patients (6.64 vs. 7.14 days) and for the non-buttress group in total hospital cost (RYGB: $26,309 vs. $25,115; SG: $20,713 vs. $19,053). Conclusions: The use of staple line buttress may be associated with shorter hospital stay in RYGB patients. However, buttress use also associates with higher hospital cost in our analysis cohort. PSY31 EVALUATING THE ECONOMIC BURDEN AND HEALTH CARE UTILIZATION OF ANEMIA IN THE US MEDICARE POPULATION Tan H 1, Xie L 1, Baser O 2, Yuce H 3, Wang Y 1 Research, Ann Arbor, MI, USA, 2Columbia University and STATinMED Research, New York, NY, USA, 3New York City College of Technology-CUNY and STATinMED Research, New York, NY, USA .
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1STATinMED
Objectives: To examine the economic burden and health care utilization of anemia in the US Medicare population. Methods: Patients diagnosed with anemia were identified (International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes: 280-285) using national Medicare data from 01JAN2009-31DEC2013. The first diagnosis date was designated as the index date. A comparison cohort was created for patients without anemia using 1:1 propensity score matching (PSM) to control demographics and the Charlson Comorbidity Index (CCI). The index date was chosen randomly for the comparison cohort to minimize selection bias. Patients in both the disease and control cohorts were required to have continuous medical and pharmacy benefits 1 year before and 1 year after the index date. Study outcomes, including health care costs and utilization, were compared between the disease and comparison cohorts based on the matched sample. Results: After 1:1 PSM matching, 234,625 patients were identified in each cohort; the baseline characteristics were well balanced. Patients with anemia were more likely to report inpatient (36.99% vs. 10.09%), emergency room (ER) (27.35% vs. 17.00%), physician office (98.06% vs. 84.93%), outpatient hospital (79.98% vs. 62.72%), Skilled Nursing Facility (SNF) (12.77% vs. 2.27%), Home Health Agency (HHA) (21.21% vs. 5.80%), and Durable Medical Equipment (DME) utilization (37.39% vs. 23.70%). Higher all-cause health care costs were also observed for anemic patients, including inpatient ($9,264 vs. $1,468), ER ($300 vs. $128), physician office ($3,484 vs. $1,792), outpatient hospital ($6,522 vs. $3,110), SNF ($2,744 vs. $420), HHA ($1,168 vs. $287), DME ($393 vs. $191), Part D pharmacy ($1,752 vs. $1,325), and total costs ($25,947 vs. $9,009; all p< 0.0001). Conclusions: During a 12-month period, Medicare patients diagnosed with anemia reported higher health care utilization and costs than their matched controls. PSY32 BURDEN OF AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE IN US MEDICARE BENEFICIARIES Clark L A , Blanchette C M , Noone J M , Zacherle E , Howden R , Shah S University of North Carolina at Charlotte, Charlotte, NC, USA .
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Objectives: Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a rare genetic disorder that affects approximately 1:2500 individuals in the United States. ADPKD symptoms develop in early to middle age adulthood and lead to chronic kidney disease and associated healthcare services. Little is known about the burden of ADPKD on the Medicare population. The objective of this cohort study was to assess the healthcare utilization and cost among Medicare beneficiaries with ADPKD. Methods: We constructed a cohort of ADPKD (ICD-9-CM: 753.12,753.13) beneficiaries from a Medicare Limited Data Set (5% sample). Beneficiaries with ≥ 2 ADPKD claims between 2011-2013 were stratified by age (≤ 39, 40-64, ≥ 65 years). Gender, clinical complications, and 12-month pre and post-diagnosis healthcare utilization and costs were described. Utilization and costs were measured using number of outpatient visits, office visits, emergency department (ED) visits, hospital stays, and length of stay (LOS). Frequencies and percentages of patient demographics, utilization, and costs were compared using bivariate statistics. Results: The study contained a sample of 1850 beneficiaries [males(52.3%), females(47.7%)] including age stratification [n= 80 (≤ 39 years), n= 671 (40-64 years), n= 1099 (≥ 65 years)]. The average Charlson Comorbidity Index (CCI) score increased with age [3.25(2.01%) ≤ 39, 3.73(2.76%) 40-64, 4.06(2.68%) ≥ 65]. Significant differences (p≤ .05) existed between pre and post-periods for utilization and costs among beneficiaries aged 40-64. There was an increase in average number of outpatient visits (9.75 to 12.51), office (10.29 to 12.83), ED visits (.85 to 1.23), hospital stays (.63 to 1.35), and LOS (.08 to .45). Results also reflected an increase in average costs associated with outpatient visits ($11919.96 to $13257.39), office visits ($1413.55 to $1710.15), ED visits ($368.51 to $594.12), and hospital stays ($8781.44 to $17535.05). Conclusions: In this study, Medicare ADPKD patients aged 40-64 experience high utilization and subsequent higher costs from year to year placing an overwhelming burden on the United States healthcare system. PSY33 COST OF DELIVERING INTRAVENEOUS OPIOID ANALGESIA IN EMERGENCY DEPARTMENTS IN THE UNITED STATES Palmer P P 1, Lemus B 1, DiDonato K 1, House J 2 1AcelRx Pharmaceuticals, Inc., Redwood City, CA, USA, 2Premier, Inc, Charlotte, NC, USA .
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Objectives: Evaluation of the cost of delivering IV opioids in the emergency department (ED) for the treatment of acute pain has been limited to date. This study estimates the cost of delivering an initial dose of an IV opioid to ED patients. Methods: Descriptive analyses using the Premier database (2013-2014) of > 600 US hospital EDs were conducted on the cost of starting an IV and delivering an initial dose of an IV opioid in EDs. Average costs of each component were aggregated for total costs. Direct acquisition and indirect cost (labor, pharmacy, etc.) were included. Results:
VA L U E I N H E A LT H 1 9 ( 2 0 1 6 ) A 1 - A 3 1 8
PSY28 HOSPITALIZATIONS FOR OLDER PATIENTS WITH ACUTE MYELOID LEUKEMIA: INPATIENT TREATMENT IS INTENSIVE AND COSTLY Sacks N 1, Cyr P 1, Noone J 1, Miller D 2, Louie A 2 for Value, Boston, MA, USA, 2Celator Pharmaceuticals, Inc., Ewing, NJ, USA .
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.
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1Precision
Objectives: Acute Myeloid Leukemia (AML) disproportionately affects older patients. Treatment often requires lengthy hospitalizations, including those for chemotherapy administration and follow-up. Recent studies suggest that outpatient management following chemotherapy may be safe and reduce costs, but information on the characteristics of AML hospitalizations is limited. The objective of this study is to characterize costs and length of stay (LOS) for hospitalizations in the US for older adults with AML. Methods: We used the 2013 Medicare Inpatient Limited Data Set (LDS) file to identify hospitalizations with a principal or secondary diagnosis of AML (ICD-9 205.0). We grouped hospitalizations by the Diagnosis Related Group (DRG) used for reimbursement and calculated mean payments and LOS by DRG. We identified hospitalizations where chemotherapy was administered using ICD9 procedure codes V58.1 and 99.25. Results: Of 12,524 hospitalizations with AML as a discharge diagnosis, AML was the principal diagnosis for 6,655 (53.1%). Mean payment for these hospitalizations was $37,198; average LOS was 13.6 days. These hospitalizations included 2,219 ICU stays with mean ICU LOS of 9.6 days. Nearly all principal AML diagnosis hospitalizations (6,563) were assigned to one of four DRGs, with payments and LOS ranging from $10,111/4.8d to $97,797/25.5d; the ICU LOS range was from 4.6d to 21.8d. Chemotherapy was administered in a subset of all AML hospitalizations (N= 3,646; 29.1%), including 2,190 where AML was principal diagnosis. For hospitalizations where chemotherapy was the principal and AML a secondary diagnosis (N= 1,357), mean payments and LOS ranged from $9,339/6.1d to $48,597/24.7d. Patients were in the ICU in only 12.6% of these hospitalizations. Conclusions: Treatment intensity and costs are high for AML patients receiving and not receiving chemotherapy. Many hospitalizations where chemotherapy is administered do not involve ICU stays, suggesting that outpatient management following chemotherapy could be safe for some patients and reduce patient burden and hospital/payer costs. PSY29 INCREMENTAL HEALTH CARE EXPENDITURES ASSOCIATED WITH DEPRESSION AMONG INDIVIDUALS WITH CUTANEOUS LUPUS ERYTHEMATOSUS Ogunsanya M , Nduaguba S O , Brown C The University of Texas at Austin, Austin, TX, USA .
.
.
.
Objectives: To estimate the incremental healthcare expenditures and utilization associated with depression among adults with CLE. Methods: Using the 2013 Medical Expenditure Panel Survey (MEPS), CLE patients with and without depression were compared to determine differences in: a) healthcare utilization – inpatient, outpatient, office and emergency room (ER) visits, and prescriptions filled; and b) expenditures – total costs, inpatient, outpatient, office-based, ER, and prescription medication costs, and other costs using demographically and comorbidity adjusted multivariate models (age, gender, race/ethnicity, marital status, poverty category, smoking status, and Charlson comorbidity index). Results: Adults with CLE and depression had more inpatient visits (0.50 vs. 0.29, p< 0.001), outpatient visits (2.05 vs. 1.15, p< 0.05), office-based visits (22.09 v 16.50, p< 0.001), ER visits (0.57 vs. 0.24, p< 0.001), and prescriptions filled (53.62 vs. 23.74, p< 0.001) than those without depression. They also had higher average annual total expenditures ($18,824 vs. $10,058). Thus, the annual total incremental medical expenditure associated with depression was estimated as $8,766(SE: $4,215; p < 0.001) per person. Officebased visit cost, estimated at $2,171 (SE: $1,365; p< 0.001) accounted for the largest proportion of the overall incremental expenditures, followed by inpatient cost at $2,780 (SE: $2,009; p< 0.05). Together, they accounted for approximately 56.4% of the total incremental cost. After adjustment, adults with CLE and depression spent 57% more on annual total healthcare expenditures than those without depression (RR = 1.57, 95% CI [0.11, 1.93]). Likewise, cost of inpatient (RR = 1.27, 95% CI [1.04, 2.59]), and prescription drugs (RR = 1.40, 95% CI [1.29, 1.68]) were associated with depression. Conclusions: Among adults with CLE, depression was associated with higher healthcare expenditures. Early diagnosis and treatment of depression in CLE patients may reduce total expenditures and utilization in this population. PSY30 DIFFERENCES IN CLINICAL OUTCOMES AND COSTS ASSOCIATED WITH THE USE OF STAPLE LINE BUTTRESS IN BARIATRIC SURGERY Ghosh S K 1, Ryan M P 2, Gache L M 2, Roy S 3, Fegelman E 4 Health Economics and Market Access, Ethicon, Inc., Cincinnati, OH, USA, 2CTI Clinical Trial and Consulting Services, Cincinnati, OH, USA, 3Johnson and Johnson Global Surgery, Somerville, NJ, USA, 4Johnson & Johnson (Ethicon), Cincinnati, OH, USA .
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.
.
.
.
.
.
1Global
Objectives: Buttress material, either absorbable or permanent, is widely used in bariatric surgery. The aim of this research was to assess differences in clinical and economic outcomes associated with the use of staple line buttress in inpatient Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) surgical procedures. Methods: Data from the Premier Perspective DatabaseTM from January 2006 to March 2014 were analyzed. Adult patients undergoing single primary SG or RYGB procedures were identified using ICD-9 codes. A keyword-based algorithm was used to identify buttress use. Assessed outcomes variables were length of stay (LOS), 30-day readmission rate, occurrence of significant bleeding (≥ 3units of transfusion blood product) and total cost to hospital. Differences between the buttress and non-buttress groups were evaluated using multivariate regression models for readmissions, LOS and total cost. Input variables for the regression models were buttress use, surgical characteristics, patient characteristics, patient comorbidities and hospital characteristics. Results: 79,041 RYGB (21,157 buttress and 57,884 non-buttress) and 28,850 SG (9,588 buttress and 19,262 non-buttress) patients were included in the analysis. Observed outcomes were slightly favorable for the buttress group: LOS (SG: 1.9±1.3 days vs. 2.1±2.8 days; RYGB: 2.4±2.7 days vs. 3.7±7.1 days),
30-day readmission (SG: 4.1% vs. 4.7%; RYGB: 7.1% vs. 8.5%) and significant blood loss (SG: 0.1% vs. 0.4%; RYGB: 0.5% vs. 1.4%). Total hospital cost was higher for the SG buttress group (SG: $11,893±7,751 vs. $11,239±9,874) and lower for RYGB buttress ($13,984±10,857 vs. $14,801±15,846). Multivariable regression analysis showed statistically significant (p< 0.05) differences in favor of the buttress group for LOS in RYGB patients (6.64 vs. 7.14 days) and for the non-buttress group in total hospital cost (RYGB: $26,309 vs. $25,115; SG: $20,713 vs. $19,053). Conclusions: The use of staple line buttress may be associated with shorter hospital stay in RYGB patients. However, buttress use also associates with higher hospital cost in our analysis cohort. PSY31 EVALUATING THE ECONOMIC BURDEN AND HEALTH CARE UTILIZATION OF ANEMIA IN THE US MEDICARE POPULATION Tan H 1, Xie L 1, Baser O 2, Yuce H 3, Wang Y 1 Research, Ann Arbor, MI, USA, 2Columbia University and STATinMED Research, New York, NY, USA, 3New York City College of Technology-CUNY and STATinMED Research, New York, NY, USA .
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1STATinMED
Objectives: To examine the economic burden and health care utilization of anemia in the US Medicare population. Methods: Patients diagnosed with anemia were identified (International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes: 280-285) using national Medicare data from 01JAN2009-31DEC2013. The first diagnosis date was designated as the index date. A comparison cohort was created for patients without anemia using 1:1 propensity score matching (PSM) to control demographics and the Charlson Comorbidity Index (CCI). The index date was chosen randomly for the comparison cohort to minimize selection bias. Patients in both the disease and control cohorts were required to have continuous medical and pharmacy benefits 1 year before and 1 year after the index date. Study outcomes, including health care costs and utilization, were compared between the disease and comparison cohorts based on the matched sample. Results: After 1:1 PSM matching, 234,625 patients were identified in each cohort; the baseline characteristics were well balanced. Patients with anemia were more likely to report inpatient (36.99% vs. 10.09%), emergency room (ER) (27.35% vs. 17.00%), physician office (98.06% vs. 84.93%), outpatient hospital (79.98% vs. 62.72%), Skilled Nursing Facility (SNF) (12.77% vs. 2.27%), Home Health Agency (HHA) (21.21% vs. 5.80%), and Durable Medical Equipment (DME) utilization (37.39% vs. 23.70%). Higher all-cause health care costs were also observed for anemic patients, including inpatient ($9,264 vs. $1,468), ER ($300 vs. $128), physician office ($3,484 vs. $1,792), outpatient hospital ($6,522 vs. $3,110), SNF ($2,744 vs. $420), HHA ($1,168 vs. $287), DME ($393 vs. $191), Part D pharmacy ($1,752 vs. $1,325), and total costs ($25,947 vs. $9,009; all p< 0.0001). Conclusions: During a 12-month period, Medicare patients diagnosed with anemia reported higher health care utilization and costs than their matched controls. PSY32 BURDEN OF AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE IN US MEDICARE BENEFICIARIES Clark L A , Blanchette C M , Noone J M , Zacherle E , Howden R , Shah S University of North Carolina at Charlotte, Charlotte, NC, USA .
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.
Objectives: Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a rare genetic disorder that affects approximately 1:2500 individuals in the United States. ADPKD symptoms develop in early to middle age adulthood and lead to chronic kidney disease and associated healthcare services. Little is known about the burden of ADPKD on the Medicare population. The objective of this cohort study was to assess the healthcare utilization and cost among Medicare beneficiaries with ADPKD. Methods: We constructed a cohort of ADPKD (ICD-9-CM: 753.12,753.13) beneficiaries from a Medicare Limited Data Set (5% sample). Beneficiaries with ≥ 2 ADPKD claims between 2011-2013 were stratified by age (≤ 39, 40-64, ≥ 65 years). Gender, clinical complications, and 12-month pre and post-diagnosis healthcare utilization and costs were described. Utilization and costs were measured using number of outpatient visits, office visits, emergency department (ED) visits, hospital stays, and length of stay (LOS). Frequencies and percentages of patient demographics, utilization, and costs were compared using bivariate statistics. Results: The study contained a sample of 1850 beneficiaries [males(52.3%), females(47.7%)] including age stratification [n= 80 (≤ 39 years), n= 671 (40-64 years), n= 1099 (≥ 65 years)]. The average Charlson Comorbidity Index (CCI) score increased with age [3.25(2.01%) ≤ 39, 3.73(2.76%) 40-64, 4.06(2.68%) ≥ 65]. Significant differences (p≤ .05) existed between pre and post-periods for utilization and costs among beneficiaries aged 40-64. There was an increase in average number of outpatient visits (9.75 to 12.51), office (10.29 to 12.83), ED visits (.85 to 1.23), hospital stays (.63 to 1.35), and LOS (.08 to .45). Results also reflected an increase in average costs associated with outpatient visits ($11919.96 to $13257.39), office visits ($1413.55 to $1710.15), ED visits ($368.51 to $594.12), and hospital stays ($8781.44 to $17535.05). Conclusions: In this study, Medicare ADPKD patients aged 40-64 experience high utilization and subsequent higher costs from year to year placing an overwhelming burden on the United States healthcare system. PSY33 COST OF DELIVERING INTRAVENEOUS OPIOID ANALGESIA IN EMERGENCY DEPARTMENTS IN THE UNITED STATES Palmer P P 1, Lemus B 1, DiDonato K 1, House J 2 1AcelRx Pharmaceuticals, Inc., Redwood City, CA, USA, 2Premier, Inc, Charlotte, NC, USA .
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.
Objectives: Evaluation of the cost of delivering IV opioids in the emergency department (ED) for the treatment of acute pain has been limited to date. This study estimates the cost of delivering an initial dose of an IV opioid to ED patients. Methods: Descriptive analyses using the Premier database (2013-2014) of > 600 US hospital EDs were conducted on the cost of starting an IV and delivering an initial dose of an IV opioid in EDs. Average costs of each component were aggregated for total costs. Direct acquisition and indirect cost (labor, pharmacy, etc.) were included. Results: