Cost Containment for Argatroban Through Reduction in Drug Waste: Experience at a Single Center

Published Online: Friday, March 22, 2013
This study and supplement was sponsored by Eagle Pharmaceuticals, Inc.

Argatroban is a direct thrombin inhibitor mainly used to treat heparin-induced thrombocytopenia.1 Argatroban is a high-cost medication; therefore, finding solutions to decrease waste and costs is important. In this retrospective analysis, the authors attempted to quantify the waste of argatroban 250 mg/250 mL at their center based on actual usage patterns, clarify where this waste happens, and determine if costs could be reduced by switching to an argatroban product with less volume per vial.

A total of 20 patients met the requirements for inclusion in the study. Total drug wasted during the product preparation and drug administration stages was calculated. Wholesale acquisition cost (WAC) was used to determine estimated total drug cost for the reconstituted 250 mg/250 mL product. Using model estimations based on actual usage of the product and WAC, potential medication usage and costs for 2 ready-to-use argatroban products, 50 mg/50 mL and 125 mg/125 mL, were determined.

A substantial amount of argatroban waste was found occurring with the 250-mg product, at both product preparation and drug administration stages, with the majority of waste occurring during drug administration. A total of 104 infusion equivalents were wasted: 36 infusions within the pharmacy and 68 infusions at site of administration. This waste represented 31% of total argatroban drug cost. Modeling indicated that utilization of the 50 mg/50 mL or 125 mg/125 mL product could substantially reduce overall waste and associated costs. Using the 50 mg/50 mL product would result in drug waste being reduced to 1% of argatroban drug cost. The 125 mg/125 mL product use would reduce waste to 2% of argatroban drug cost 

1. Warkentin TE, Greinacher A, Koster A, et al. Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. 8th ed. Chest. 2008;133(suppl):340S-380S.

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