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Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients
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| Zeitschriftentitel: | Clinical and Applied Thrombosis/Hemostasis |
|---|---|
| Personen und Körperschaften: | , , , , |
| In: | Clinical and Applied Thrombosis/Hemostasis, 24, 2018, 1, S. 186-191 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
SAGE Publications
|
| Schlagwörter: |
| author_facet |
Ciolek, Alana Lindsley, John Crow, Jessica Nelson-McMillan, Kristen Procaccini, David Ciolek, Alana Lindsley, John Crow, Jessica Nelson-McMillan, Kristen Procaccini, David |
|---|---|
| author |
Ciolek, Alana Lindsley, John Crow, Jessica Nelson-McMillan, Kristen Procaccini, David |
| spellingShingle |
Ciolek, Alana Lindsley, John Crow, Jessica Nelson-McMillan, Kristen Procaccini, David Clinical and Applied Thrombosis/Hemostasis Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients Hematology General Medicine |
| author_sort |
ciolek, alana |
| spelling |
Ciolek, Alana Lindsley, John Crow, Jessica Nelson-McMillan, Kristen Procaccini, David 1076-0296 1938-2723 SAGE Publications Hematology General Medicine http://dx.doi.org/10.1177/1076029617693941 <jats:p>Thrombate III is a human plasma-derived antithrombin III (AT-III) often utilized in patients on extracorporeal membrane oxygenation (ECMO) with suspected AT-III-mediated heparin resistance. It is supplied as 500-U and 1000-U vials, costing US$4.66 per unit. Literature is limited in describing the clinical value of AT-III in relation to its high cost. The primary objective was to determine conditions of use and associated cost of potentially unnecessary utilization of AT-III at The Johns Hopkins Hospital. Secondary objectives included evaluating the effect of AT-III on anticoagulation parameters and the overall cost utilized and wasted on AT-III. A retrospective cohort study was performed. The primary end point was the total cost associated with potentially unnecessary utilization of AT-III. There were 326 doses of AT-III administered to 65 patients in 2014. There were 177 (54%) potentially unnecessary doses associated with a cost of US$541 634. Antithrombin III repletion significantly increased median AT-III levels in non-ECMO and ECMO patients compared to baseline (non-ECMO: 62% vs 81%, P < .01; ECMO: 63% vs 81%, P < .01); however, 37.3% of ECMO and 49% of non-ECMO patients had therapeutic anticoagulation monitoring parameters prior to administration. A total cost of US$688 478 was spent on administered AT-III and US$417 194 (38%) was wasted. Utilizing restriction criteria and a new dosing strategy potentially results in estimated annual savings of US$556 000. Utilizing restriction criteria and alternative dosing strategies to mitigate waste and unnecessary use has the potential to result in significant cost savings.</jats:p> Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients Clinical and Applied Thrombosis/Hemostasis |
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| title |
Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_unstemmed |
Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_full |
Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_fullStr |
Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_full_unstemmed |
Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_short |
Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_sort |
identification of cost-saving opportunities for the use of antithrombin iii in adult and pediatric patients |
| topic |
Hematology General Medicine |
| url |
http://dx.doi.org/10.1177/1076029617693941 |
| publishDate |
2018 |
| physical |
186-191 |
| description |
<jats:p>Thrombate III is a human plasma-derived antithrombin III (AT-III) often utilized in patients on extracorporeal membrane oxygenation (ECMO) with suspected AT-III-mediated heparin resistance. It is supplied as 500-U and 1000-U vials, costing US$4.66 per unit. Literature is limited in describing the clinical value of AT-III in relation to its high cost. The primary objective was to determine conditions of use and associated cost of potentially unnecessary utilization of AT-III at The Johns Hopkins Hospital. Secondary objectives included evaluating the effect of AT-III on anticoagulation parameters and the overall cost utilized and wasted on AT-III. A retrospective cohort study was performed. The primary end point was the total cost associated with potentially unnecessary utilization of AT-III. There were 326 doses of AT-III administered to 65 patients in 2014. There were 177 (54%) potentially unnecessary doses associated with a cost of US$541 634. Antithrombin III repletion significantly increased median AT-III levels in non-ECMO and ECMO patients compared to baseline (non-ECMO: 62% vs 81%, P < .01; ECMO: 63% vs 81%, P < .01); however, 37.3% of ECMO and 49% of non-ECMO patients had therapeutic anticoagulation monitoring parameters prior to administration. A total cost of US$688 478 was spent on administered AT-III and US$417 194 (38%) was wasted. Utilizing restriction criteria and a new dosing strategy potentially results in estimated annual savings of US$556 000. Utilizing restriction criteria and alternative dosing strategies to mitigate waste and unnecessary use has the potential to result in significant cost savings.</jats:p> |
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| author | Ciolek, Alana, Lindsley, John, Crow, Jessica, Nelson-McMillan, Kristen, Procaccini, David |
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| description | <jats:p>Thrombate III is a human plasma-derived antithrombin III (AT-III) often utilized in patients on extracorporeal membrane oxygenation (ECMO) with suspected AT-III-mediated heparin resistance. It is supplied as 500-U and 1000-U vials, costing US$4.66 per unit. Literature is limited in describing the clinical value of AT-III in relation to its high cost. The primary objective was to determine conditions of use and associated cost of potentially unnecessary utilization of AT-III at The Johns Hopkins Hospital. Secondary objectives included evaluating the effect of AT-III on anticoagulation parameters and the overall cost utilized and wasted on AT-III. A retrospective cohort study was performed. The primary end point was the total cost associated with potentially unnecessary utilization of AT-III. There were 326 doses of AT-III administered to 65 patients in 2014. There were 177 (54%) potentially unnecessary doses associated with a cost of US$541 634. Antithrombin III repletion significantly increased median AT-III levels in non-ECMO and ECMO patients compared to baseline (non-ECMO: 62% vs 81%, P < .01; ECMO: 63% vs 81%, P < .01); however, 37.3% of ECMO and 49% of non-ECMO patients had therapeutic anticoagulation monitoring parameters prior to administration. A total cost of US$688 478 was spent on administered AT-III and US$417 194 (38%) was wasted. Utilizing restriction criteria and a new dosing strategy potentially results in estimated annual savings of US$556 000. Utilizing restriction criteria and alternative dosing strategies to mitigate waste and unnecessary use has the potential to result in significant cost savings.</jats:p> |
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| spelling | Ciolek, Alana Lindsley, John Crow, Jessica Nelson-McMillan, Kristen Procaccini, David 1076-0296 1938-2723 SAGE Publications Hematology General Medicine http://dx.doi.org/10.1177/1076029617693941 <jats:p>Thrombate III is a human plasma-derived antithrombin III (AT-III) often utilized in patients on extracorporeal membrane oxygenation (ECMO) with suspected AT-III-mediated heparin resistance. It is supplied as 500-U and 1000-U vials, costing US$4.66 per unit. Literature is limited in describing the clinical value of AT-III in relation to its high cost. The primary objective was to determine conditions of use and associated cost of potentially unnecessary utilization of AT-III at The Johns Hopkins Hospital. Secondary objectives included evaluating the effect of AT-III on anticoagulation parameters and the overall cost utilized and wasted on AT-III. A retrospective cohort study was performed. The primary end point was the total cost associated with potentially unnecessary utilization of AT-III. There were 326 doses of AT-III administered to 65 patients in 2014. There were 177 (54%) potentially unnecessary doses associated with a cost of US$541 634. Antithrombin III repletion significantly increased median AT-III levels in non-ECMO and ECMO patients compared to baseline (non-ECMO: 62% vs 81%, P < .01; ECMO: 63% vs 81%, P < .01); however, 37.3% of ECMO and 49% of non-ECMO patients had therapeutic anticoagulation monitoring parameters prior to administration. A total cost of US$688 478 was spent on administered AT-III and US$417 194 (38%) was wasted. Utilizing restriction criteria and a new dosing strategy potentially results in estimated annual savings of US$556 000. Utilizing restriction criteria and alternative dosing strategies to mitigate waste and unnecessary use has the potential to result in significant cost savings.</jats:p> Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients Clinical and Applied Thrombosis/Hemostasis |
| spellingShingle | Ciolek, Alana, Lindsley, John, Crow, Jessica, Nelson-McMillan, Kristen, Procaccini, David, Clinical and Applied Thrombosis/Hemostasis, Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients, Hematology, General Medicine |
| title | Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_full | Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_fullStr | Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_full_unstemmed | Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_short | Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| title_sort | identification of cost-saving opportunities for the use of antithrombin iii in adult and pediatric patients |
| title_unstemmed | Identification of Cost-Saving Opportunities for the Use of Antithrombin III in Adult and Pediatric Patients |
| topic | Hematology, General Medicine |
| url | http://dx.doi.org/10.1177/1076029617693941 |