EVALUATION OF THE FINANCIAL IMPACT OF KETOROLAC TROMETHAMINE THERAPY IN HOSPITALIZED-PATIENTS

This retrospective cohort study aimed to determine the resource utiliz ation and cost consequences of ketorolac tromethamine in postoperative pain management in a variety of clinical circumstances. All patients were treated at LDS Hospital, Salt Lake City, Utah, a 520-bed teaching hospital. A long-term archive of clinical and financial data from a c omputerized hospital information system was searched for patients with specified primary International Classification of Diseases, 9th Revis ion, Clinical Modification discharge diagnoses treated from June 1, 19 90, to July 1, 1992, who received ketorolac (n = 229). These patients were matched with cohort patients (n = 821) treated from July 1, 1989, to May 31, 1990, who did not receive ketorolac. The archive contained information on ketorolac exposure as well as concurrent drug therapy and adverse drug events that had been prospectively evaluated during h ospitalization throughout the study and cohort periods. Detailed costs were available for each patient. The study examined attributable diff erences in lengths of stay and total costs using linear regression mod eling. We found a statistically significant attributable decreased len gth of stay for ketorolac patients of 1.15 days. Case patients also ha d reduced usage of narcotic drugs (4.39 fewer doses than cohorts and 1 5.6 hours shorter duration of narcotics than cohorts), reduced use of antiemetic and antipruritic medications, and reduced numbers of advers e events. Linear regression modeling showed that ketorolac use was sig nificantly related to reduced cost using inflation-adjusted dollars. W e believe that ketorolac has significant cost advantages over opiate a nalgesics because of its narcotic-sparing effects. Advantages of ketor olac use inelude reduced rates of adverse drug events, reduced lengths of stay, especially for orthopedic surgery, and reduced overall hospi tal costs for diagnosis-related groups associated with cholecystectomy .