Contrast and Cost Savings by Implementation of a Multidose Bulk IV Contrast Delivery System

Abstract

In an effort to standardize clinical operations and reduce intravenous (IV) contrast costs, the authors' department switched from 100-mL single-use IV contrast vials to a multidose IV contrast delivery system using iopromide 370. The purpose of this study was to assess IV contrast use, waste, and cost savings resulting from the implementation of this multidose system. A review was conducted of consecutive pulmonary embolism (PE) CT angiography, head and neck (HN) CT angiography, and abdomen/pelvis (AP) CT examinations performed according to standard department protocol 2 weeks before and 2 weeks after the implementation of a multidose IV contrast delivery system. The amount of contrast loaded and injected for each examination was recorded, and total contrast used and wasted were calculated. Volumes of used and wasted contrast were compared before and after implementation using Wilcoxon's rank-sum test. Associated cost savings are reported. There were 32 PE, 27 HN, and 124 AP examinations performed using the 100-mL single-use vial technique and 27 PE, 25 HN, and 175 AP examinations using the multidose technique. Use of the multidose system resulted in average reductions in used contrast volume of 15.9, 35.1, and 11.4 mL, respectively, for PE, HN, and AP examinations (Wilcoxon's P < .0001). For PE and HN examinations, this was due to reduced contrast waste, as these protocols require less than the 100-mL contents of the single-use vial. For AP examinations, savings were due to reduction in contrast volume through the use of higher iodine concentration. Associated cost savings annualize to approximately $31,800 for these 3 examination types alone at the authors' institution. The implementation of a multidose bulk IV contrast material delivery system results in significant contrast and cost savings.