From the April 2014 issue of HealthCare Business News magazine


“We’ve developed a new presentation size for Eovist,” says Dennis Durmis, head of the Americas region for Radiology & Interventional at Bayer HealthCare. Durmis says the contrast medium, which is used for imaging the liver in adults, is now available in a 15mL single-dose vial to image patients weighing more than 220 pounds. Gadavist, an MR-enhancing contrast medium used to image the central nervous system in adults and children older than 2, is now available in a 2mL single-dose vial- for imaging of pediatric patients weighing 44 pounds or less.

“It’s ultimately up to the hospital to decide how they want to leverage individual vial sizes or whether they want to go the pharmacy bulk package route,” says Durmis. “Both are still out there and being used in different ways, but it certainly has been a big topic of discussion.”


The demand from customers and the subsequent response from manufacturers does make sense. Contrast is fairly expensive as consumables go and while bulk packaging can save facilities money, contrast use is governed by the same rules and regulations surrounding pharmaceuticals. In the case of bulk packaging, it means any unused contrast has to be disposed of 24 hours after it’s opened. For facilities with a large volume of patients, it’s unlikely to be an issue, but for smaller hospitals, individually packaged single-dose solutions can be attractive.

“Our customers are often looking at ways that contrast use can be expanded based on new studies and literature,” said Melissa Layman, vice president of Global Marketing at Lantheus Medical Imaging in an emailed response. “In August of 2013, we added a new packaging option for DEFINITY. We heard from our customers about packaging waste and space constraints and developed a new 16-vial pack that is more compact, cost efficient, and sustainable. With our 16-vial pack option, one cold chain box can fit up to 64 vials.”

With fewer packages, Layman says customers can streamline processes and reduce paperwork, produce less waste and save space.

The smaller delivery sizes will likely gain in popularity as equipment continues to get more sophisticated and therefore require less contrast to obtain optimum results. “High-speed CT scanners today are more involved with reconstruction algorithms,” says Sandra Schaffer, product manager of CT for Bracco. “You need less dose volume now than you did 10 or 15 years ago,” she says.

For the foreseeable future, with noted exceptions like SonoVue waiting in the wings, it’s likely that efforts will be focused on efficiency and cost control when it comes to contrast.

“With the ACA’s continued pressure on reimbursement and the price pressure with that, it’s really forcing companies to drive more efficient, lower-cost solutions instead of newer, more novel concepts,” says Bayer’s Durmis. “It’s forcing us to shift from the way we’ve historically invested our resources.” Betsy Rose, head of marketing for MR & ultrasound at Bracco Diagnostics Inc., shares a similar sentiment. “We are working with customers who are anticipating having to respond to meaningful use criteria and they’re trying to manage accordingly,” she says. Those customers are consolidating and managing staff in a way that they can do more with less according to Rose. “We’re partnering with them to respond to the demands and needs of this environment,” she says.

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