I have no contacts with Pharmacy. We had no idea what dye cost until I asked
our nurse educator the other day. West Coast retina has had problems as well
and could not get dye for their private clinic from the hospital to my
knowledge despite the fact they work here much of the time. Last time BC
revisited the cost of FA it was when dye was a few dollars and RN's made less
than half what they make now.
Chris
________________________________
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On ;
Behalf Of Krista Peters
Sent: Tuesday, March 15, 2016 1:29 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: FA dye dosage
Appreciate the info Chris. I called VGH pharmacy but they'll only sell to
Macdonalds pharmacy at that price due to their longstanding relationship.
Macdonalds will sell it to us for $479. Do you have a contact at VGH pharmacy
that might be willing to give us a better rate so we can purchase directly from
them?
Krista
On Mar 15, 2016, at 7:29 AM, Carlton, Chris [VA]
<Chris.Carlton@xxxxxx<mailto:Chris.Carlton@xxxxxx>> wrote:
Krista the 10% is supplied by Alcon in Canada is currently $ 367.20 for 12
vials from our VGH pharmacy.
Multinational Drug Company gouging sounds more like capitalism than socialized
medicine. 50 Canadian is currently $37.50 not 30.
Chris Carlton
UBC/VGH ECC
________________________________
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Krista Peters
Sent: Friday, March 11, 2016 4:17 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: FA dye dosage
We get ours from Eye supply. It's $299.40 for 12x5mL vials. We then have to pay
$1500 in custom charges and we're ordering every 3 months. I've just heard
Alcon also supplies it within Canada so I'll be touching base with them to see
if we can cut costs there.
Krista
On Mar 11, 2016, at 3:33 PM, CPMC Ophthalmic Diagnostic Center
<cpmceyelab@xxxxxxxxxxxxxxxx<mailto:cpmceyelab@xxxxxxxxxxxxxxxx>> wrote:
50.00 Canadian is still 30.00 American!
Where are you getting your fluorescein, Fort Knox?
Or is that national medicine, save on the front end, pay on the back end.....?
Wow.....
Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937 FAX (415) 600-6563
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Cynthia VandenHoven
Sent: Friday, March 11, 2016 3:31 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: FA dye dosage
Yes. Our Toronto docs know alot of your Vancouver docs and your volume is
massive.
And our Retina doc said each vial of fluorescein is $50 Cdn. The price went up
about 6 yrs ago. We don't have easy access to the cost of consumables cos we
don't bill patients or insurance companies for every procedure or consumable we
use.
$50 a vial is the cost doing business in Canada. I don't know if the $50 price
is the price before our dollar dropped or after. Ie if the 50 dollar cost was
based on the increase 6yrs ago. Then easily that same vial is close to 70
now...
So yeah I can see why the bean counters are wondering if you can use less
dye....
Cynthia VandenHoven
Medical Imaging Specialist, Hospital for Sick Children, Toronto Canada
On Mar 11, 2016 12:49 PM, "CPMC Ophthalmic Diagnostic Center"
<cpmceyelab@xxxxxxxxxxxxxxxx<mailto:cpmceyelab@xxxxxxxxxxxxxxxx>> wrote:
That would explain it!
Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937<tel:%28415%29%20600-3937> FAX (415)
600-6563<tel:%28415%29%20600-6563>
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] On
Behalf Of Krista Peters
Sent: Friday, March 11, 2016 9:22 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: FA dye dosage
We have 6 OCT's between 4 satellite offices and 5 retina specialists. A huge
diabetic population and common practice to do angiograms on every new
WetAMD/RVO patient.
Krista
On Mar 11, 2016, at 8:30 AM, CPMC Ophthalmic Diagnostic Center
<cpmceyelab@xxxxxxxxxxxxxxxx<mailto:cpmceyelab@xxxxxxxxxxxxxxxx>> wrote:
Wow! 100 angiograms a week! Sounds like the old days. Either you have a
huge diabetic population or don't own an OCT?
Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937<tel:%28415%29%20600-3937> FAX (415)
600-6563<tel:%28415%29%20600-6563>
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Krista Peters
Sent: Thursday, March 10, 2016 5:43 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: FA dye dosage
Thanks for your input Denise et al
I'm not involved in the purchasing of the dye (although maybe I need to be) but
our accountant is saying we're spending close to 25k every 3 months. We do
about 75-100 angiograms per week. We're in Vancouver Canada and I hear it's
been difficult for us to find a company to ship to Canada. Then there's added
custom charges etc...
I'm thinking we need to investigate a cheaper company that ships to Canada
instead of compromising quality images.
Krista
On Mar 10, 2016, at 4:45 PM, CPMC Ophthalmic Diagnostic Center
<cpmceyelab@xxxxxxxxxxxxxxxx<mailto:cpmceyelab@xxxxxxxxxxxxxxxx>> wrote:
Costs? I think a vial is up to a whopping 8.00 at the present time
Isn't that splitting hairs a bit? Like shorting on the GenTeal when doing a
biometry
Cost of doing business
I cannot see the point of cutting anything in half to save money
The term "Allergic" reaction is sure thrown around lightly. You have to
really ratchet up a normal reaction to the procedure ( vasovagal) or even mild
hives to begin to fill the criteria of a compromised airway, aka "Allergic"
One hears that term thrown around from everything from gluten to the color
pink. Check out the references and you will see that the peer reviewed
literature on reactions to sodium fluorescein for ophthalmic use are mighty
Slim indeed. Nausea is not an allergic reaction. It's a contraction of the
large smooth muscle of the stomach more often or not caused by nerves,
clenching, lack of breathing.
Ana, do a literature search on the OPS Website. You will see a number of
articles discussing these issues that have been discussed for four decades now.
AAO's OMIC group also has a few well worded missives on the subject.
Us old dogs in the field will tell you that PATIENT MANAGEMENT goes a long way
to lessening reactions, not cutting your vial in half.
Respectfully,
Denice
Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937<tel:%28415%29%20600-3937> FAX (415)
600-6563<tel:%28415%29%20600-6563>
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Ana Mills
Sent: Thursday, March 10, 2016 2:40 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: FA dye dosage
Hi Krista,
Ana here, how does your office manager feel about using the 10% fluorescein? I
use the 10% and I always only use 2.5cc for every patient, to cut costs, and to
cut down on the likelihood of an allergic reaction for the patient. With that
combo, I've noticed that it is very rare that I have patients with
nausea/vomiting or itching, etc., which is nice for everyone. My images very
typically still end up being of very high quality, and we don't blow through
our fluorescein supply too quickly. I'm not sure what the price difference is
between the 5% and 10%, but I think you should try to get your office to start
just buying the 10% and always only using 2.5cc per patient. I've been in the
field for five years now, and so far this is definitely my preferred way of
administering the fluorescein injections. I'm curious to see if they let you
switch!
Ana A. Mills
Ophthalmic Photographer/Technician
DC Retina, Dr. Neal Adams, M.D.
2101 Medical Park Drive, Suite 303
Silver Spring, MD 20902
Business phone: (301) 754-1200<tel:%28301%29%20754-1200>
On Mar 10, 2016, at 5:27 PM, Krista Peters
<krista_81@xxxxxxxxxxx<mailto:krista_81@xxxxxxxxxxx>> wrote:
My office manager is wanting to cut costs by lowering the dosage of FA dye from
5cc to 2.5cc. We are using a 5% dye and currently cut the dosage for people
with renal issues and those images are rarely as good as when using the full
5cc. My manager is claiming that lots of clinics are doing this. Do any of you
only use 2.5cc with 5%?? I'd be curious to know your thoughts so I can try to
convince the doctors otherwise.
Krista
