Contrast Agents

It was the aim of the assessment to analyse the many different non-ionic (monomer) contrast media products on the actual clinical relevance of their differences in order to give advice for a more concerted purchasing of CM.

Introduction:

In the context of the increasing economic pressure upon hospital-budgets, considerations on central purchasing of pharmaceuticals arise. The assessment was carried out (and paid for by) the biggest Austrian hospital cooperation (25% of hospital market). Seven different NI-CM are used in routine care.

Results:

• Osmolality, nephrotoxicity, viscosity, hydrophilicity and electric charge are the criteria by which the CM can be differentiated.
• The analyzed NI-CM show similar pharmacokinetic and -dynamic attributes,
• All analysed NI-CM are safe in their application. The incompatibility and adverse reactions are minimal, the diagnostic accuracy at a comparable high level.
• If the iodine concentration and the (intravasal) application – protocol are similar, there are only minimal or non-reproducible differences in safety and diagnostic quality.
• There are no clinically relevant differences between the 7 (analysed) different non-ionic monomer CM-products.
• By valid definitions, the products are me-too preparations – under patent protection.
• In response to the many me-too pharmaceuticals and the enormous price-differences between EU-countries the purchasing units of hospitals have started to react: quite interesting models evolve.

Conclusion:

A decision on concentrating on 2-3 products would mean 30% less expenses for CM. A decision between three strands of (re-)actions among hospital purchasers were identified and are proposed as options: 1. tightening the product range on the basis of best clinical performance (e.g. vigilance register) or best offers or cumulated radiologists' preferences. 2. an inquiry into industry's financial support for technical material, education and training, congresses etc., followed by own price-calculation without add-ons (but creating an independent fund) and tender by price instead of by product. 3. linking commissioning with conditions (comparative research from users perspective, education and training on purchasers topics, payment into an independent-administered fund).