As you have heard, OFIRMEV (IV acetaminophen) will not be available for analgesia in adults or pediatrics, beginning March 1, 2018 (THIS THURSDAY!). It will still be available for Patent Ductus Arteriosus closure in neonates and for certain fevers with VERY STRICT criteria (see FormWeb).

It is highly likely that a physician may contact you about this drug, whether it be for a simple question like "why is it no longer available?," or in anger that he/she cannot order this drug. The rep has been very active lately and has even reached out to me to talk (I declined!). Here are a few points that you may want to make if you are pressed on the topic:

• This decision was made by the High Value Care Committee (chaired by Chief Medical Officer, Robert Chappell), to whom it was referred by P&T for a final decision. It has been confirmed by the Medical Executive Committee (on which all division chiefs sit) and is firmly backed by the P&T.
• There is plentiful evidence that OFIRMEV has little clinical benefit at a relatively high cost. We have reviewed studies in various patient populations, including those in whom it has been requested at HH. When we approached one of the original requesters of this drug and informed him that it would no longer be available, he replied that he didn't see a clinical benefit from the drug. The DI Center can provide you with an article summary upon request
• At this time, there are NO EXCEPTIONS to the ban on use of OFIRMEV for analgesia. If physicians or groups want to petition the High Value Care Committee for an exception, they may contact Dr. Chappell's office to be added to the agenda. His Administrative Assistance is Alison Greene, ext. 56990.
• It is highly unlikely that any of the current users (bariatrics, colo-rectal surgery, Drs. Kibry/Engle) will have a patient who meets criteria for use of OFIRMEV for fever, so it should not be verified/supplied in these patients.
• If OFIRMEV is ordered and entered into iCare for analgesia, please delete it from the patient's profile.
• If the prescriber is insistent, belligerent, or otherwise hostile and you are unable to come to a satisfactory conclusion of the conversation, please refer him/her to Dr. Chappell.

As always, feel free to contact me with questions. DAVID

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David R. Collette, Pharm.D., FASHP
Operations Manager, Professional Services