(P-TS-118) Wastage and Cost Analysis for Intercept Fibrinogen Complex

Transfusion of Intercept Fibrinogen Complex (IFC) is designed to decrease product wastage vs a 5-pool of conventional cryoprecipitated AHF (cryoAHF) due to the 5-day vs 6-hour expiration at room temperature.  Wastage costs may be markedly reduced by using IFC.  This study compared product acquisition costs for transfused and wasted products during a one-year clinical trial when the blood bank was randomized monthly to use of either cryoAHF or IFC20 (IFC with ~2.2 g fibrinogen) at a large quaternary care academic medical center (~115,000 type & screens and 25,000 RBCs, 10,000 Platelets, 4,000 Plasma and 1,200 cryoAHF transfused per year).     

Study

Design/Methods:

Total number of transfused and wasted products were collected from the blood bank LIS, including reasons for wastage for the 482 adult patients who received cryoAHF or IFC from April 1, 2023 to March 31, 2024.  Reasons for wastage were categorized as clinical trial related wastage, supplier-related reimbursed wastage (e.g., breakage while thawing or failed visual inspection), and clinical wastage (i.e.,expired on the floor or in the blood bank).  Only clinical wastage was analyzed.

Results/Findings: During the six cryoAHF months, 671 5-pools (annualized 1342 pools) were transfused to 238 patients and during the six IFC months, 586 6-pools (annualized 1172 pools) were transfused to 244 patients. During the cryoAHF months, 139 units (17% of total units thawed) were attributed to clinical wastage.  There were 12.7% less IFC units transfused to slightly more patients (244 vs 238) during the cluster-randomized study periods, indicating less doses administered to patients receiving IFC (2.4 vs 2.8). Only eight IFC units (1% of total units thawed) were attributed to clinical wastage. As pathogen-reduced blood products cost more to manufacture, we estimated different price points based on our experience with the increased costs of such components. Table 1 compares the total cost of both products at various hypothetical price points for IFC and assumes a fixed $350 cost for a five-pool of cryoAHF.  At $500 per unit, IFC, would cost the institution an additional $71,650 annually ($149 per patient). At $1,000 per unit IFC, it would cost the institution an additional $661,650 ($1,373 per patient). (Table 1)

Conclusions:

There was a 94% reduction in clinical wastage during the IFC study period. In this study, based only on wastage, an IFC price of $439.28 would be cost neutral.  However, other benefits of IFC should be considered in the value proposition including: reduced time to fulfill urgent orders, increased sense of security with readily available cryoprecipitate, decreased infectious risk due to pathogen reduction, and more standardized fibrinogen content.