The Skyrocketing Cost of Rectal Indomethacin

Acute pancreatitis is the most common major complication of endoscopic retrograde cholangiopancreatography (ERCP), occurring in 3% to 15% of cases and in up to 40% of procedures if preventive measures are not used. About 5% of patients who develop pancreatitis after ERCP have a severe course, characterized by local and systemic complications, prolonged hospitalization, and occasional death. Considering that about 600,000 ERCPs are performed annually in the US, ERCP-related pancreatitis is an important and costly problem. Here, Elmunzer et al discuss the rising cost of rectal indomethacin medication, a drug used for preventing pancreatitis following ERCP.