Price hike drives IV Acetaminophen out of reach for emergency medicine – right where it is needed most.
Recently I wrote a column extolling the benefits of IV acetaminophen and asking why more emergency clinicians weren’t using the drug. On the face of it, the arguments for its use were pretty straightforward – no opiate sedation or nausea and the potential for less opiates to be used (or omitted entirely).
To my mind there were only two reasons that IV acetaminophen wasn’t being used – physicians weren’t aware of the product and its potential value (the reason for my column) and the potential price tag. When first released, the drug was $13 a gram. Those comparing the costs of IV acetaminophen vs IV opiates (perhaps $1) had what appeared to be a good case for not using the drug (or using it sparingly and for specific indications). My position, however, was that given the cost of an average ED visit exceeds an embarrassing $1,200, the price difference between the drugs was inconsequential.
However, my initial information on the price of the drug turned out to be incorrect.
Now I find out that the manufacturer of the drug has decided to take away any rational reason to use the drug. As with other seemingly absurd increases in the cost of drugs that have been reported recently, the powers that be have decided to raise the price of IV acetaminophen from a ridiculous $13 to $35.
Paradoxically, the ED would be the ideal environment to push the use of this drug. Lots and lots of people present with pain and, except for IV ketololac, which has many issues of its own, the ability to be able to give a reasonable alternative analgesic to opiates is very appealing.
Not any more. It seems the manufacturer, as a result of its actions, has decided to effectively kill the use of their drug. At $35 a dose, nobody is going to use it in the ED and hospital pharmacy committees are going to sharply restrict the use of the IV version of the drug to the point of extinction. As well they should.
My apologies for any confusion my column may have caused. I will work to keep any future drug recommendations up to date with current pricing. Thanks for reading.