A Retrospective Study of Patients Undergoing Gastrointestinal Surgery with or without Receiving Alvimopan: Comparing Length of Stay and Total Direct Cost

Objective: Alvimopan (Entereg®) has been shown to accelerate the recovery time of upper and lower gastrointestinal (GI) system following partial large or small bowel resection with primary anastomosis. Alvimopan acquisition cost can increase health care costs. The purpose of this study is to assess the effectiveness of alvimopan reducing the length of stay (LOS) and total direct cost in patients undergoing gastrointestinal surgery. Materials and methods: Data was collected using the Crimson Clinical Advantage software. The software identified 64 patients who underwent major small and large bowel surgical procedures from July 2018 to February 2019. Patients’ demographics, comorbidities, and treatment details were collected. Two groups where analyzed, patients that received alvimopan 12mg twice daily for up to 15 doses or until patients discharged, which ever occur first, with controls (patients who did not receive alvimopan). The data was retrospectively collected from patient records at Hialeah Hospital. The primary endpoints included reduction in both length of stay and total direct cost. Results: The study reviewed 64 patients that met the inclusion criteria, 33 (51.5%) of these patients received alvimopan. When comparing both groups, alvimopan treatment was associated with a reduced duration mean of hospitalization (4.48 vs 7.39 days, P < 0.01). In addition, almivopan was also associated with a significant reduction of the average total direct cost for treatment group ($7,965 vs $9,100), a difference of 12.4%. Conclusion: Patients who undergo segmental bowel resection with primary anastomosis and received alvimopan had a reduction of the length of stay and total direct costs compared with control group.