Frank Peacock, MD: Methylnaltrexone for OIC is More Effective, Less Expensive

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Emergency medicine specialist urges hospitals to add methylnaltrexone to the hospital formulary after promising research shows the treatment's success with opioid-induced constipation.

A common adverse event that accompanies long-term opioid use for pain management is opioid-induced constipation (OIC). More than 30,000 adult patients with-opioid induced constipation were identified for a study from a hospital-based database (2016–2019).

In this interview, Frank Peacock, MD, Baylor College of Medicine, discussed his research “Opioid-Induced Constipation: Cost Impact of Approved Medications in the Emergency Department”, which was recently published in Advances in Therapy.

The study provided a real-world retrospective examination of the cost associated with treating opioid-induced constipation with methylnaltrexone in an emergency department (ED) setting, as well as the drug's effectiveness to do so.

The biggest obstacle with using methylnaltrexone is gaining access to it. Peacock's data indicated it's less expensive and more effective than other treatment methods and many patients treated with it avoided hospitalization. Those who didn't had a much shorter stay.

Peackock emphasized that if it's not on the formulary, emergency department doctors will not be able to access methylnaltrexone when they need it. However, he shared his success in approaching the pharmacist with a gastroenterologist or another specialist from the hospital.

"So, that's the most successful way to approach this," he explained, "is get somebody from another department who agrees with you to go talk to the pharmacist about putting it on the on the formulary."