Product Selection and Pharmaceutical Comparison of Two Anti-D Immune Globulins

Abstract

Purpose Two anti-D immunoglobulin (anti-D) products, Rhophylac and WinRho, have been approved by the US Food and Drug Administration for the treatment of chronic immune thrombocytopenic purpura. There is a significant difference in acquisition cost—and perhaps in preparation cost—of the products. This time-and-motion study was designed to evaluate the difference in time and relevant costs required for preparation of a single dose of anti-D immunoglobulin using these 2 products. Methods To evaluate the difference in time required for preparation of a single dose (3,600 mcg) of the 2 anti-D immunoglobulins for a patient weighing 72 kg, each product was prepared 9 times and the time for each preparation was recorded. The cost analysis was limited to comparison of the acquisition costs of both anti-D products and the incremental labor costs associated with their preparation. Results The results showed that the average total time for 9 preparations of WinRho was 1 minute 30.1 seconds, with the assembly time comprising 46.7 seconds. The average total time for the 9 preparations with Rhophylac was 5 minutes 7.1 seconds, with an average assembly time of 2 minutes 59.2 seconds. The difference in total average time between the 2 products was 3.62 minutes. Conclusion The cost comparison showed that the acquisition cost for as single dose of WinRho for a patient weighing 72 kg was $2,647 and that the cost for the same dose of Rhophylac was $946. Even with a personnel cost of $20 per hour, the increased labor cost is only $1.20 per preparation of Rhophylac. This is a minor cost compared to the $1,850 savings in product acquisition per average dose of Rhophylac.