Managing acute acetaminophen poisoning with oral versus intravenous N-acetylcysteine: A provider-perspective cost analysis

Journal of Medical Economics

Volumn 12, Issue 4, 2009, Pages 384-391

  Marchetti, Albert ^a,b   Rossiter, Richard ^a  

^a Medical Education and Research Alliance (Med ERA Inc)   (United States)

^b UNIVERSITY OF MEDICINE AND DENTISTRY OF NEW JERSEY   (United States)

Author keywords

Acetaminophen; Costs; N acetylcysteine; Poisoning

Indexed keywords

ACETYLCYSTEINE; PARACETAMOL;

ACETAMINOPHEN POISONING; ARTICLE; CONTROLLED STUDY; COST BENEFIT ANALYSIS; COST CONTROL; DRUG COST; DRUG OVERDOSE; EXPERIMENTAL MODEL; HEALTH CARE COST; HEALTH CARE UTILIZATION; HOSPITALIZATION; INTENSIVE CARE UNIT; OUTCOME ASSESSMENT; WARD;

ACETAMINOPHEN; ACETYLCYSTEINE; ACUTE DISEASE; ADMINISTRATION, ORAL; ANALGESICS, NON-NARCOTIC; ANTIDOTES; COSTS AND COST ANALYSIS; DRUG-INDUCED LIVER INJURY; HUMANS; INJECTIONS, INTRAVENOUS; LENGTH OF STAY; MODELS, ECONOMIC; OVERDOSE; TIME FACTORS; UNITED STATES;

EID: 72749093794     PISSN: 13696998     EISSN: None     Source Type: Journal    
DOI: 10.3111/13696990903435829     Document Type: Article

References (25)

1. Bronstein AC, Spyker D, Cantilena LR, et al. 2007 Annual report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 25th annual report. Clin Toxicol 2008;46:927-1057.
2. US Food and Drug Administration. Public health problem of liver injury related to the use of acetaminophen in both over-the-counter (OTC) and prescription (RX) products. Available at: http://www.fda.gov/AdvisoryCommittees/ Calendar/ ucm143083.htm. Accessed August 25, 2009.
3. Buckley NA, Whyte IM, O'connell DL, et al. Oral or intravenous N-acetylcysteine: which is the treatment of choice for acetaminophen (paracetamol) poisoning? J Toxicol Clin Toxicol 1999;37:759-767
4. Prescott LF, Illingworth RN, Critchley JAJH, et al. Intravenous N-acetylcysteine: the treatment of choice in acetaminophen poisoning. BMJ 1979;2:1097-1100
5. Parker D, White JP, Paton D, Routledge PA. Safety of late acetylcysteine treatment in paracetamol poisoning. Hum Exp Toxicol 1990;9:25-27
6. Smilkstein MJ, Bronstein AC, Lindein C, et al. Acetaminophen overdose: a 48-hour intravenous N-acetylcysteine treatment protocol. Ann Emerg Med 1991;20:1058-1063
7. Rumack BH, Peterson RC. Acetaminophen overdose: incidence, diagnosis, and management if 416 patients. Pediatrics 1978;62:898-903.
8. Rumack BH, Peterson RC, Koch GG, Amara IA. Acetaminophen overdose. 662 cases with evaluation of oral acetylcysteine treatment. Arch Intern Med 1981;141(3 Spec No):380-385
9. Smilkstein MJ, Knapp GL, Kulig KW, et al. Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose: analysis of the national multicenter study (1975 to 1985). N Engl J Med 1988;319:1557-1562
10. Culley CM, Krenzelok EP. A clinical and pharmacoeconomic justification for intravenous acetylcysteine: a US perspective. Toxicol Rev 2005;24:131-143
11. Prescribing Information. Mucomyst? (acetylcysteine) Solution. Roxane Laboratories, Inc. Revised March 2007.
12. Prescribing Information. Acetadote? (acetylcysteine) Injection. Cumberland Pharmaceuticals Inc., 2006.
13. Ferris M, Hasket M, Pilkington S, Williams M. Financial analysis of acetaminophen suicide in a teen girl. Ped Nurs 2007;33:422-541.
14. Yarema MC, Johnson DW, Berlin RJ, et al. Comparison of the 20-hour intravenous and 72-hour oral acetylcysteine protocols for the treatment of acute acetaminophen poisoning. Ann Emerg Med. Published Online, 2009.
15. Friedman B, De la mare J, Andrews R, McKenzie DH. Practical options for estimating cost of hospital inpatient stays. J Health Care Finance 2002;29:1-13.
16. Kanter MZ. Comparison of oral and i.v. acetylcysteine in the treatment of acetaminophen poisoning. Am J Health-Syst Pharm 2006;63:1821-1827
17. Bond GR, Novak JE. The human and economic cost of acetaminophen (acetaminophen) overdose. Pharmacoeconomics 1995;8:177-181
18. Flanagan RJ, Meredith TJ. Use of N-acetylcysteine in clinical toxicology. Am J Med 1991;91:131-9S.
19. Sunman W, Hughes AD, Sever PS. Anaphylactoid response to intravenous acetylcysteine. Lancet 1992;339:1231-1232
20. Yip L, Dart RC, Hurlbut KM. Intravenous administration of oral N-acetylcysteine. Crit Care Med 1998;26:40-43
21. Bailey B, Mcguigan MA. Management of anaphylactoid reactions to intravenous N-acetylcysteine. Ann Emerg Med 1998;31:710-715
22. Larson AM. Acetaminophen hepatotoxicity. Clin Liver Dis 2007;11:525-548
23. Fontana RJ. Acute liver failure including acetaminophen overdose. Med Clin N Am 2008;92:761-794
24. Dasta JF. Daily cost of an intensive care unit day: the contribution of mechanical ventilation. Crit Care Med 2005;33:1266-1271
25. Evans RW, Manninen DL, Dong FB. An economic analysis of liver transplantation, costs, insurance coverage, and reimbursement. Gastroenterol Clin North Am 1993;22:451..