PNS39 Wastage and Costs of Contrast MEDIA in Computed Tomography in the UK: Comparison of MULTI-Dose Versus Single-Dose Bottles

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Iodinated contrast media for computed tomography (CT) imaging are often available in single-dose bottles where any unused amount must be discarded after one utilization, while multi-dose bottles allow multiple dosages with lower amount of waste. Iomeron (iomeprol) is a non-ionic iodinated contrast medium used in numerous indications including CT enhancement. In addition to different sizes and concentrations of single-dose bottles, Iomeron is approved in the UK also in multi-dose 500 ml bottles (300–350–400 mgI/ml). The objective of this analysis was to compare the amount of wasted contrast media and total costs for multi-dose and single-dose bottles, respectively. A cost-calculator was developed to compare a current scenario for which all CTs were performed using 300 mgI/ml in 100 ml single-dose bottles (applied with syringe power injector) versus two future scenarios considering either a) concentration of 300 mgI/ml in 500 ml multi-dose bottles or b) 400 mgI/ml in 500 ml multi-dose bottles (both applied with syringeless power injector). For each scenario the amount of wastage, the price of contrast media (assuming costs per iodine gram were equal for each bottle size and concentration), cost of radiographer and consumables were considered. Average iodine dose and number of contrast enhanced CTs (CE-CT) were derived from a market research database, other costs and resource uses were derived from economic literature. Based on an estimated number of 2.06 million CE-CTs performed in 2019 in the UK with contrast media containing 300 mgI/ml, the total costs in current scenario were £40.8 million, compared to £26.9 and £25.4 million in scenario a) and b), respectively. Switching to multi-dose bottles could reduce wastage of contrast media by up to 86%. Switching from single-dose to multi-dose bottles of contrast media and from syringe to syringeless power injector can significantly reduce wastage and associated costs of performing CE-CTs scans.