Big price increases for two radiotracers have led imaging facilities to look for alternatives, with at least some success. The tracers are used in ventilation/perfusion scans of patients with suspected pulmonary embolism.
As we reported in May, Jubilant DraxImage of Montreal increased the prices of macroaggregated albumin (MAA) and diethylenetriamine pentaacetate (DTPA). The company is the sole North American manufacturer of both. At least one nuclear medicine physician said the per-vial price for MAA increased by more than 2,000 percent. Jubilant DraxImage, in a statement published May 15, said that figure was inaccurate and “misrepresents the price difference seen by the end user.” The company estimated that customers would instead see a 500 percent increase.
DOTmed News now reports that some facilities have switched for the ventilation portion of the scan from DTPA to pyrophosphate (PYP). Herman A. Kensky, MD, of Mercy Imaging Centers in the Sacramento, California, area told DOTmed News that he has been using PYP for a few weeks:
I can’t tell the difference when looking at the images, and my technologists say that there’s no difference in performance to date. If price is the only difference, we’re going to stay with this new method.
There’s no equivalent tracer that can substitute for MAA during the perfusion part of the scan, but some imaging centers have been looking at an alternative source: compounding pharmacies. AnazaoHealth Corporation of Tampa, Florida, said it began making custom-compounded MAA vials during a shortage of MAA last September. At that time, the custom-compounded vials were more expensive than the commercial kits from Jubilant DraxImage. Now, they’re cheaper.
Robert G. McKenzie, AnazaoHealth senior vice president of research and development, said the company has been receiving more calls about MAA since the Jubilant DraxImage price hike, but he credited the quality of his company’s product rather than its price for nuclear medicine facilities’ increased interest. “I believe it’s because they see the clinical value in custom preparations,” he said.
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Related CME seminar (up to 12 AMA PRA Category 1 credits™): UCSF Cardiovascular & Pulmonary Imaging