It seems like there is an arms race in flow cytometry with labs selling and leading with messaging and sales pitch on performing 10 color flow. Are there labs offering 12 color? Isnt compensation rate limiting for clinical utility? We are looking at the FDA approved 10 color panels from Beckman Coulter, but I’m worried that 2-3 years from now it might not be enough. Any thoughts? Thanks!
12 color flow clinical lab?
- Thread starter elburrito
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For some reason this just sounds like low hanging fruit for the payors.
The number of colors is irrelevant and often creates compensation issues as the number of flourochromes increase. You can do flow with 4 colors just fine. Stanford was doing 4 color flow as recently as 5 years ago on most cases. If you are trained well, you should be able to make assessments across tubes just fine. 10 color flow is more than enough. The main issue with new instrumentation is doing MRD flow if your leukemia volume is high enough to warrant it. That has reduced the volume of flow in my practice significantly.
I completely agree that in skilled operators hands, fewer colors is technically sufficient and increasing colors only complicates color compensation requirements and increases potential for nonspecific or background staining. Unfortunately, sales and market demand may be an issue for some labs.
Is anyone using 12 color for their routine clinical testing?
Is anyone using 12 color for their routine clinical testing?
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Yes there is an arms race in FC at the moment. You can absolutely do 4 color flow and get an answer, but you're only reimbursed once per antibody. So for 4 color flow across 10 tubes, the lab is eating any repeat antigens - like CD45 x 9 if they're doing CD45 vs. SS gating on every tube.
Therefore, the more colors you run in a single tube, the less redundancy and more savings/efficiency in terms of reagent and tech time. But of course, it won't be long before payors drop the reimbursement to ensure that any savings you manage to squeeze out of your investment are negligible. So if there's no long term financial incentive, I'm not sure what the end point is other that to ultimately give the service for not much more than a routine CBC.
Therefore, the more colors you run in a single tube, the less redundancy and more savings/efficiency in terms of reagent and tech time. But of course, it won't be long before payors drop the reimbursement to ensure that any savings you manage to squeeze out of your investment are negligible. So if there's no long term financial incentive, I'm not sure what the end point is other that to ultimately give the service for not much more than a routine CBC.
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