Inexpensive Supplies

[Aether2000]

I would like this thread to reflect inexpensive supply information that we can share with each other. I have no relationship with any of the suppliers.

Radiofrequency Needles for all the major generators:
(Neurotherm, Cosman, Kimberly Clark/ Baylis and Stryker)

ONLY $11.00 per needle (sold in boxes of 25)

Spectra Medical Devices- RF Cannula with RAF Technology (Reduced Advance Force)
(RAF Technology™ and Reduced Advance Force™ (patent pending), are property of Spectra Medical Devices Inc.)

In stock and ready to ship:
CURVED CANNULA
GRF-42010-C RF Curved Cannula, 10cm, 20 gauge, 10 mm exposed tip, curved spinal
GRF-62010-C RF Curved Cannula, 15cm, 20 gauge, 10 mm exposed tip, curved spinal
STRAIGHT CANNULA
GRF-2225-S RF Straight Cannula, 5cm, 22 gauge, 5 mm exposed tip, Straight spinal
GRF-42205-S RF Straight Cannula, 10cm, 22 gauge, 5 mm exposed tip, Straight spinal
GRF-62010-S RF Straight Cannula,15cm, 20 gauge, 10 mm exposed tip, Straight spinal

Call or email today!

C 2 Medical Distributors Inc.
[email protected]
312-884-1050

---

Members don't see this ad.

 

[Aether2000]

INEXPENSIVE CONTRAST

ISIS leadership is excited to provide members with this outstanding benefit!

ISIS is keenly aware of the difficulties facing interventional pain physicians. A barrage of insurance payment cuts and healthcare policy changes over the past several years have significantly inhibited your ability to provide continued access to care for many of your patients. In an era of bundled payments, the CDC single dose vial policy, while promoting the safest injection practices, has contributed to a major cost dilemma; and the recent compounding company tragedy has only worsened concerns regarding the safety of pursuing other avenues of single dose vials. We understand that the obstacles to providing quality care can seem overwhelming.

ISIS has always diligently researched ways to assist our members in providing the highest quality evidence-based best care, be it through our education and research efforts, advocacy, or representation at state, regional or governmental forums.

After thoroughly investigating numerous options, in response to the vexing single dose vial issues and escalating supply costs, the ISIS leadership is happy to announce the formation of a unique partnership with PedsPal, a national physician Group Purchasing Organization, or GPO. Working with ISIS, PedsPal has structured a discount program that is only available to ISIS members. The program is specifically targeted to offer the best pricing on the medications, equipment and supplies that are most important to you. As an example, through the GPO plan, Omnipaque 240 mg/50 ml can be purchased as low as $4.61 per vial.

A Few Details

The GPO pricing is exceptionally competitive across the board, and the range of services is truly unmatched, as PedsPal is willing to work with each participating practice to maximize available savings. Enclosed is a sample of the pricing, which we think you will be eager to access via this special program.

ISIS does not pay PedsPal and the products are not marked-up. Instead PedsPal receives an administrative fee (approximately 3%) from the GPO supplier, Henry Schein, a medical supply distributor. PedsPal then shares one half of the administrative fee with ISIS, which directs the monies in support of vitally important Research, Education and Advocacy projects. This administrative fee does not impact your discount; rather Henry Schein, the source supplier, treats it as a marketing cost.

Joining is simple, costs nothing and can be cancelled with a 10 day Notice

 

[Ligament]

God bless you.

I have no sources of suppliers for anything significantly cheaper than the rest, however I can recommend a certain brand of echogenic needles for U/S guided procedures that are affordable compared to Pajunk and Braun echogenic needles.

http://www.havels.com/ultrasound-needle-echoblock-msk-echogenic.html

These Hakko needles are of high quality steel, made in Japan, and are 90% as echogenic as the German Pajunk needles and possibly more echogenic than the Braun needles. About 40-50% cheaper than Pajunk and Braun as well.

They really pay off for deep injections such as pudendal, obturator, hip injections.

 

[pmrmd]

Now I know how bad Henry Schein was raping me for all those years...

 

[pastafan]

INEXPENSIVE CONTRAST

ISIS leadership is excited to provide members with this outstanding benefit!

ISIS is keenly aware of the difficulties facing interventional pain physicians. A barrage of insurance payment cuts and healthcare policy changes over the past several years have significantly inhibited your ability to provide continued access to care for many of your patients. In an era of bundled payments, the CDC single dose vial policy, while promoting the safest injection practices, has contributed to a major cost dilemma; and the recent compounding company tragedy has only worsened concerns regarding the safety of pursuing other avenues of single dose vials. We understand that the obstacles to providing quality care can seem overwhelming.

ISIS has always diligently researched ways to assist our members in providing the highest quality evidence-based best care, be it through our education and research efforts, advocacy, or representation at state, regional or governmental forums.

After thoroughly investigating numerous options, in response to the vexing single dose vial issues and escalating supply costs, the ISIS leadership is happy to announce the formation of a unique partnership with PedsPal, a national physician Group Purchasing Organization, or GPO. Working with ISIS, PedsPal has structured a discount program that is only available to ISIS members. The program is specifically targeted to offer the best pricing on the medications, equipment and supplies that are most important to you. As an example, through the GPO plan, Omnipaque 240 mg/50 ml can be purchased as low as $4.61 per vial.

A Few Details

The GPO pricing is exceptionally competitive across the board, and the range of services is truly unmatched, as PedsPal is willing to work with each participating practice to maximize available savings. Enclosed is a sample of the pricing, which we think you will be eager to access via this special program.

ISIS does not pay PedsPal and the products are not marked-up. Instead PedsPal receives an administrative fee (approximately 3%) from the GPO supplier, Henry Schein, a medical supply distributor. PedsPal then shares one half of the administrative fee with ISIS, which directs the monies in support of vitally important Research, Education and Advocacy projects. This administrative fee does not impact your discount; rather Henry Schein, the source supplier, treats it as a marketing cost.

Joining is simple, costs nothing and can be cancelled with a 10 day Notice

Wow, what amazing news. When did this GPO start? Of all my ISIS emails I didn't get one advertsing this service.

 

[pastafan]

http://www.clintpharmaceuticals.com/clint_Procedural_Epidural_Trays.html#safetytrays

The tray pricing and Tuohy prices are very reasonable.

http://www.insightneedles.com/collections/quincke

Cheap needle pricing.

 

[powermd]

I entered my contact info at pedspal.org to get a temporary password. I don't see a specialty listing for anesthesia or pain, and among the specialties listed, Omnipaque was no where to be found.

How do we obtain this deal?

INEXPENSIVE CONTRAST

ISIS leadership is excited to provide members with this outstanding benefit!

ISIS is keenly aware of the difficulties facing interventional pain physicians. A barrage of insurance payment cuts and healthcare policy changes over the past several years have significantly inhibited your ability to provide continued access to care for many of your patients. In an era of bundled payments, the CDC single dose vial policy, while promoting the safest injection practices, has contributed to a major cost dilemma; and the recent compounding company tragedy has only worsened concerns regarding the safety of pursuing other avenues of single dose vials. We understand that the obstacles to providing quality care can seem overwhelming.

ISIS has always diligently researched ways to assist our members in providing the highest quality evidence-based best care, be it through our education and research efforts, advocacy, or representation at state, regional or governmental forums.

After thoroughly investigating numerous options, in response to the vexing single dose vial issues and escalating supply costs, the ISIS leadership is happy to announce the formation of a unique partnership with PedsPal, a national physician Group Purchasing Organization, or GPO. Working with ISIS, PedsPal has structured a discount program that is only available to ISIS members. The program is specifically targeted to offer the best pricing on the medications, equipment and supplies that are most important to you. As an example, through the GPO plan, Omnipaque 240 mg/50 ml can be purchased as low as $4.61 per vial.

A Few Details

The GPO pricing is exceptionally competitive across the board, and the range of services is truly unmatched, as PedsPal is willing to work with each participating practice to maximize available savings. Enclosed is a sample of the pricing, which we think you will be eager to access via this special program.

ISIS does not pay PedsPal and the products are not marked-up. Instead PedsPal receives an administrative fee (approximately 3%) from the GPO supplier, Henry Schein, a medical supply distributor. PedsPal then shares one half of the administrative fee with ISIS, which directs the monies in support of vitally important Research, Education and Advocacy projects. This administrative fee does not impact your discount; rather Henry Schein, the source supplier, treats it as a marketing cost.

Joining is simple, costs nothing and can be cancelled with a 10 day Notice

 

[Pain Applicant1]

I entered my contact info at pedspal.org to get a temporary password. I don't see a specialty listing for anesthesia or pain, and among the specialties listed, Omnipaque was no where to be found.

How do we obtain this deal?

You need to be a member of ISIS, you then receive ISIS pricing.

 

[powermd]

You need to be a member of ISIS, you then receive ISIS pricing.

I am a member of ISIS. That doesn't change the prices not being listed for pain management.

Again, my question is how does one go about obtaining these prices? Do I call ISIS? Do I call pedspal.org, tell them I am a member of ISIS, then they allow me to place an order?

And how do I turn this blasted spell checker off??

 

[Aether2000]

There is a link for isis members....I will find it

 

[pastafan]

There is a link for isis members....I will find it

https://spinalinjection.site-ym.com/?page=GPO

 

[powermd]

Why is Omni 180 in the 10 mL vials $14/vial in boxes of 10, whereas Omni 240 in 50 mL vials is $4.70/vial, also for boxes of 10?

That makes no sense at all. I thought the whole idea ISIS was going for was reduced prices for small vials.

 

[Aether2000]

Omni 180 has always been at least 3 times as expensive as Omni 240. It is supply and demand.....Omni 180 is not as commonly used as the 240. ISIS has been able to lower the price of omnipaque to the point you can throw away 49ml and still make a decent profit on procedures.... This is what we have been waiting for....affordable contrast in single dose (albeit huge doses) vials.

 

[Pain Applicant1]

...but even omnipaque 240 10ml tends to be more expensive than 50ml vials in many places. I could never figure out the answer why and supply vs demand just doesn't make sense.

 

[nvrsumr]

I may have to reup my expired Isis membership.

 

[emd123]

I'm joining Isis and switching to omnipaque 240; dilute to 180 when needed. I'd be a fool not to. I'm paying $47 per 20ml omnipaque 180 right now. It's insane. One order will pay for membership.

 

[Jcm800]

Omni 180 has always been at least 3 times as expensive as Omni 240. It is supply and demand.....Omni 180 is not as commonly used as the 240. ISIS has been able to lower the price of omnipaque to the point you can throw away 49ml and still make a decent profit on procedures.... This is what we have been waiting for....affordable contrast in single dose (albeit huge doses) vials.

i cannot wait to throw away 490 mls of contrast away a day...

 

[Aether2000]

It would be interesting to see the environmental impact statement on the increase wastage...

 

[nvrsumr]

Just reupped my ISIS memebership for 2 years. thanks Algos

 

[emd123]

Has anyone ordered the $4 Omnipaque 240, yet? I'm just wondering if there is some ridiculous catch, contract required or other strings attached (beyond ISIS membership).

 

[emd123]

bump

Anyone else with cheap supply sources?

 

[nvrsumr]

My staff is looking into the contrast. My practice had to join some Home Depot buyers club for it...

CIPM 800.343.9334 analog discography manometers for $50. Thanks Steve

 

[lobelsteve]

My staff is looking into the contrast. My practice had to join some Home Depot buyers club for it...

CIPM 800.343.9334 analog discography manometers for $50. Thanks Steve

I love them.

My staff forgot to order and I had to use a 400psi kypho manometer for my last disco. Ugg.

Love CIPM.

 

[nvrsumr]

Any good vendors for inexpensive depo medrol? I think Im paying $1000 for box of 25 10ml thru Clint.

 

[Aether2000]

Inexpensive UDS: AMP, BAR, BUP, BZO, COC, MTD, METH, OPI300, OXY, THC $3.09
Note: this includes buprenorphine, picks up oxycodone at 100ng/ml, valium at 100ng/ml, xanax at 75ng/ml, klonopin at 300ng/ml, restoril at 100ng/ml, and klonopin at 300ng/ml.

American Bio Medica Corporation www.abmc.com
Sheila Powers representative 800-227-1243 ext 126

 

[Ligament]

I was just informed that ASIPP and Clint pharmaceuticals may be offering a group purchasing organization on contrast. Does anybody have info on this GPO? How does it compare to the ISIS/pedspal GPO? Thanks!

 

[emd123]

LOL! When i first read your post this is how I saw it:

Inexpensive AMP, BAR, BUP, BZO, COC, MTD, METH, OPI300, OXY, THC $3.09Note: this includes buprenorphine,

Not exactly what you posted.

 

[agenda893]

.

 

[bedrock]

so has anyone on this board actually purchased contrast via the ISIS discount????????????

 

[lobelsteve]

$29.97 box of 10 Omnipaque 240.

VHA/Premier contract price.

Yup, $2.97 per bottle of 50cc.

 

[Aether2000]

WOW! How times have changed!

 

[jsaul]

$29.97 box of 10 Omnipaque 240.

VHA/Premier contract price.

Yup, $2.97 per bottle of 50cc.

what is VHA? can I get contact info

 

[nvrsumr]

what is VHA? can I get contact info

1+

I had PSS match the ISIS number

 

[lobelsteve]

Vha is veteran health admin. Premier is a natl purchasing org.

No. I am not at or affiliated with vamc. But we may have a sponsor to allow us to contract.

 

[bedrock]

I was asked to mention where I'm getting $4 of depo 40mg.

Not a big secret. I get them from Mckesson, and I get a volume and loyalty discount.

However, the ISIS group discount cost is $3.50 of depo 40mg, so I'm planning on getting my depo and my contrast via their purchasing group in the future.

 

[clubdeac]

I was asked to mention where I'm getting $4 of depo 40mg.

Not a big secret. I get them from Mckesson, and I get a volume and loyalty discount.

However, the ISIS group discount cost is $3.50 of depo 40mg, so I'm planning on getting my depo and my contrast via their purchasing group in the future.

Sorry just to clarify, you're paying $4 for one 40mg vial of depo?? Nooo that's not cheap

 

[bedrock]

Sorry just to clarify, you're paying $4 for one 40mg vial of depo?? Nooo that's not cheap

again I just posted that figure and vendor in response to a request.

It is certainly cheaper to buy large multi-dose vials of depomedrol than single dose vials.

However, the large multi-dose vials have higher concentrations of preservatives than single-dose vials.

Algos please chime in here. You know more about this than anyone else, Am I off base with the relative amount of preservative in multi-dose vs single dose vials?

I feel patients have fewer side effects in general, and a lower chance of arachnoiditis when using a steroid with the lowest possible concentration of preservatives, so I that's why I use single dose vials.

They pay for their insurance, I can pay $3.50-$7 for their steroid.
I do use large vials of commercially manufactured preservative-free lidocaine and large vials of contrast, which I use throughout the day, wipe after each case, and then throw away at end of the day so my total medication cost is about $10-12 per procedure.

 

[Aether2000]

Multidose vials of depomedrol are significantly different than single dose vials. The multidose contains benzyl alcohol, a neurotoxin, that was found in the earlier formulations of depomedrol that were linked to arachnoiditis, especially in Oz. Kenalog was labeled "not for epidural use" due to the benzyl alcohol content that is virtually an identical amount that is found in multidose depomedrol. Therefore IMHO, multidose vials of depomedrol are fine for intraarticular joint injections such as the z-joints, hip, knee, sacroiliac, etc, but I would use single dose in epidural applications and in the C1/2 joint (due to some spread into the epidural space).

 

[lobelsteve]

Multidose vials of depomedrol are significantly different than single dose vials. The multidose contains benzyl alcohol, a neurotoxin, that was found in the earlier formulations of depomedrol that were linked to arachnoiditis, especially in Oz. Kenalog was labeled "not for epidural use" due to the benzyl alcohol content that is virtually an identical amount that is found in multidose depomedrol. Therefore IMHO, multidose vials of depomedrol are fine for intraarticular joint injections such as the z-joints, hip, knee, sacroiliac, etc, but I would use single dose in epidural applications and in the C1/2 joint (due to some spread into the epidural space).

Care to review any of that literature here?

Been using multidose vials since 2007 for Celestone and Dex. I do not trust compounding pharmacies for epidural meds. I never bought into the Burton Report and thought the OZ problem was a formulation issue with wrong concentration and other agents besides the BA.

 

[Aether2000]

Well, that is my opinion based on reading of the articles and litigation in Oz. However, I believe Nik wrote a defense of using neurotoxic agents in steroids given their low final concentration. The quaternary ammonium salts (benzalkonium chloride, MGPC) are probably less neurotoxic than the alcohols, but much depends on concentration....

 

[lobelsteve]

Well, that is my opinion based on reading of the articles and litigation in Oz. However, I believe Nik wrote a defense of using neurotoxic agents in steroids given their low final concentration. The quaternary ammonium salts (benzalkonium chloride, MGPC) are probably less neurotoxic than the alcohols, but much depends on concentration....

Just re-read the chapter in Slipman's Interventional Spine: Ok to use Celestone, Kenalog, etc based on this text.

Fenton mentions only not to mix steroid with LA containing preservatives as flocc may occur. Lennard says same thing.

Raj discusses complications of subarachnoid injections of MPA containing steroids. Nelson and coworkers has 2/23 patients get arachnoiditis after a total of 83 subarachnoid injections.

 

[bedrock]

Just re-read the chapter in Slipman's Interventional Spine: Ok to use Celestone, Kenalog, etc based on this text.

Fenton mentions only not to mix steroid with LA containing preservatives as flocc may occur. Lennard says same thing.

Raj discusses complications of subarachnoid injections of MPA containing steroids. Nelson and coworkers has 2/23 patients get arachnoiditis after a total of 83 subarachnoid injections.

Slipman and fenton are quite a bit out of date. Hopefully an updated version would at least mention the FDA labeling on kenalog....

It just makes sense that a lower concentration of preservative would have less neurotoxic effects.

I would argue that using single dose steroid vial is the best medium ground between compounded preservative free, which has infection risks, and between the other extreme which is a multi-dose vial of commercial steroid which has a higher concentration of alchohol and other preservatives to kill any bugs while it lies partially used on the self of an orthopedic surgeon.

Single dose steroid vial for epidurals and multi-dose steroid vials for almost everything else, facets, peripheral joints, SIJ, etc, makes sense.

Why not, the only thing limiting you from doing it would be cost, and I thought you were above such considerations?

 

[lobelsteve]

Slipman and fenton are quite a bit out of date. Hopefully an updated version would at least mention the FDA labeling on kenalog....

It just makes sense that a lower concentration of preservative would have less neurotoxic effects.

I would argue that using single dose steroid vial is the best medium ground between compounded preservative free, which has infection risks, and between the other extreme which is a multi-dose vial of commercial steroid which has a higher concentration of alchohol and other preservatives to kill any bugs while it lies partially used on the self of an orthopedic surgeon.

Single dose steroid vial for epidurals and multi-dose steroid vials for almost everything else, facets, peripheral joints, SIJ, etc, makes sense.

Why not, the only thing limiting you from doing it would be cost, and I thought you were above such considerations?

Supplies are not charged to me nor do I pay for them. But I see no reason in the literature to use preservative free injectate in the epidural space. And I cannot find anything reasonable to tell me otherwise. That's why I posted. Looking for answers.

 

[nvrsumr]

Anyone know a deal on steril US sheaths? I think Im paying $4+ for 12 in. with rubberbands and gel.

Cholorprep swabs? No vet supplies fo rme Steve. hah

 

[bedrock]

Supplies are not charged to me nor do I pay for them. But I see no reason in the literature to use preservative free injectate in the epidural space. And I cannot find anything reasonable to tell me otherwise. That's why I posted. Looking for answers.

At this point I'm not advocating that you have to use preservative-free steroids for epidurals, simply that it makes sense to use commercially prepared steroid with the smallest concentrations of preservatives, (which are single dose vials).

There is no good in vivo trial of epidurals with and without preservatives. Such a trial would likely not make it past a modern IRB.

The best evidence out there are the studies evaluating the neurotoxicity of preservatives that are contained in steroids, and all of the preservatives have been shown to be neurotoxic and that the neurotoxicity was a function of concentration. (Algos has more info on this than I do)

So I extrapolate that it would be in the best interest of my patients to use commercially prepared steroid with the lowest concentration of steroid for epidurals, (which are single use vials of commercially manufactured steroid)..

(I'm not talking about compounded preservative-free steroids).

 

[bedrock]

Sorry just to clarify, you're paying $4 for one 40mg vial of depo?? Nooo that's not cheap

BTW, I just checked my supplies and apparently, I'm getting brand name depomedrol (single use vial) for $3.50 per 40mg or $7 per 80mg. This is the same price you get from the ISIS discount. All of my supplies are cheaper than the ISIS discount option, other than contrast.
Contrast is way cheaper with the ISIS discount!

So if $7 isn't cheap, do you have a supplier of single dose commercially manufactured Depo-medrol that is cheaper than $7 per 80mg?

Please share with the class.

 

[PMR2008]

Anyone know a deal on steril US sheaths? I think Im paying $4+ for 12 in. with rubberbands and gel.

Cholorprep swabs? No vet supplies fo rme Steve. hah

What procedures are you using sterile US sheaths for? Also can you just use a sterile glove as a sheath? Just saying because I saw it being used by anesthesiologists at my former hospital to do blocks. You can buy 100 sterile ultrasound gel foil pouches for 65-70 bucks.

 

[Ducttape]

most times i dont even use sterile sheath, since i use it for peripheral blocks. (I dont use US for "spine" procedures, with the exception of stellates).

i wipe off the probe with chlorhexidine wipe immediately prior to placing it on the patient, and when done with procedure..

i do use sterile prep with sterile gel, however.

 

[nvrsumr]

Use sterile sheath for all procedures. I wear sterile gloves and mask as well. Perform all in my procedure suite. Primarily art of medicine.

 

[clubdeac]

BTW, I just checked my supplies and apparently, I'm getting brand name depomedrol (single use vial) for $3.50 per 40mg or $7 per 80mg. This is the same price you get from the ISIS discount. All of my supplies are cheaper than the ISIS discount option, other than contrast.
Contrast is way cheaper with the ISIS discount!

So if $7 isn't cheap, do you have a supplier of single dose commercially manufactured Depo-medrol that is cheaper than $7 per 80mg?

Please share with the class.

I thought we were getting it cheaper than that. Let me double check next week and I'll find out the price. Also while I'm here, what quinke needles is everyone using? I used BD brand at the VA which I really liked. My current practice has ordered something else, can't remember the name but they suck. They are apparently cheaper than BD. Curious to hear what brand needles everyone uses.