RiaSTAP

Although the FDA approved CSL-Behring’s RiaSTAP, human plasma-derived fibrinogen concentrate in 2009, it seems most facilities continue to use cryoprecipitate to treat hypofibinogenemia, dysfibrinogenemia, and afibrinogenemia. Has your institution switched to RiaSTAP? Why, or why not?

For the answer, see this reference provided by George’s UAB colleague, pathologist Lawrence A. Williams III: 

“After adjusting for 28% wastage and technologist salary, CRYO cost is $414/5-unit pool. Depending on the dose, FC is more expensive by $976-$1303. To be competitive with cryo, FC cost must decrease by 44% or be shown to save 0
25–0
66 ICU days. Of the 30 survey replies, 96
7% of US centres do not use FC for acquired bleeding with the top three reasons being cost (30%), off-label usage (27%) and insufficient evidence for usage (20%). Only 47% are willing to pay more for FC, with $437/g as the median amount.”
Okerberg CK, Williams LA 3rd, Kilgore ML, Kim CH, Marques MB, Schwartz J, Pham HP. Cryoprecipitate AHF vs. fibrinogen concentrates for fibrinogen replacement in acquired bleeding patients–an economic evaluation. Vox Sang. 2016;111:292–8.