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  • * $1M+ savings through removing Ofirmev from inpatient formulary
  • * Clinical evidence did not support price premium of 10x-40x higher than comparators
  • * Identified key surgical physician specialties responsible for majority of Ofirmev utilization


  • Approved in 2010 as a non-opioid, parenteral analgesic used to manage acute pain
  • US health systems currently spend over $290M per year with greater than 10% annual growth
  • While priced 10 to 40 times higher than comparators, clinical evidence does not support manufacturer claims of superiority


A multistate, not-for-profit integrated delivery network on the East Coast was concerned about a sharp increase in annual spend for parenteral analgesics but was unsure of the root cause.


Lumere’s web-based Utilization Management solution identified a 30% increase in Ofirmev spend. After reviewing 200+ published journal articles and trials, Lumere recommended that the system remove Ofirmev from its inpatient formulary. Given the drug’s similar efficacy and safety compared to other parenteral analgesics, its clinical benefits did not offset the higher cost.

  • IV APAP, NSAIDs, and ketamine result in similar patient satisfaction when compared to IV opioids.
  • Based on limited evidence, IV formulations of NSAIDs and ketamine result in comparable pain scores to IV opioids, while IV APAP is similarly effective to IV NSAIDs and similar to or superior to IV opioids.
  • An opioid-sparing effect has been demonstrated with NSAIDs but not with IV APAP or ketamine.
  • The literature documents reduced length of stay of up to 0.5 days but only for a small selection of orthopedic surgery patients.

Lumere analyzed the health system’s data to determine the key surgical physician specialties responsible for the majority of utilization and involve these groups in the decision process. System leaders collaborated with Lumere to further analyze physician-level utilization, review additional evidence and develop a tactical plan to facilitate change.


Removing Ofirmev from formulary will yield a projected $1M+ in annual savings — 54% off a base spend of $2.2M – without negatively impacting clinical quality or patient outcomes.


annual savings in Ofirmev spend


savings in parenteral anelgesics


impact on outcomes