Stress Test

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DrugRX

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Lexiscan VS Persantine

What's in your formulary for stress test?

Lexiscan (0.4mg/ml) has a J-code (its billing unit is per 1mg), but still so much more expensive than Persantine.

Lexiscan is more selective so less side effects. Most of all, we don't have to make it.
 
DrugRX said:
Lexiscan VS Persantine

What's in your formulary for stress test?

Lexiscan (0.4mg/ml) has a J-code (its billing unit is per 1mg), but still so much more expensive than Persantine.

Lexiscan is more selective so less side effects. Most of all, we don't have to make it.
Click to expand...


It's a scam. Astellas owns both Adenoscan (Adenosine) and Lexiscan. There were 2 patents for Adenoscan. The first patent that recently expired in May 2009 dictated end user of the product to only use brand Adenoscan in Myocardial Perfusion Imaging (MPI). This means you couldn't take a bunch of generic Adenosine vials and mix it for MPI stress test.

The 2nd patent deals with continuous infusion of Adenosine in 13 or 15 different situations (Stress Test included) where if adenosine is involved in CI, then it has to be brand Adenoscan...this patent expires in 2013 in which Teva challenged in court. Instead of fighting this, Astellas settled out of court and is allowing Teva to manufacture large vial generic Adenosine in 2011 or 2012 which can be used in Stress Test and CI situations.

In order to protect themselves, Astellas is feverishly marketing Lexiscan to position themselves with continuous revenue by having Lexiscan added to hospitals throughout the country. They are doing this by pricing it about $10 cheaper than Adenoscan 30ml vials.

Generic Adenosine would cost around $50 per stress test..where brand Adenoscan 30ml costs around $190...and Lexiscan at around $180. The pricing may vary according to GPO.

Thanks for reading.
 
👍👍


StaviZFingerZ said:
It's a scam. Astellas owns both Adenoscan (Adenosine) and Lexiscan. There were 2 patents for Adenoscan. The first patent that recently expired in May 2009 dictated end user of the product to only use brand Adenoscan in Myocardial Perfusion Imaging (MPI). This means you couldn't take a bunch of generic Adenosine vials and mix it for MPI stress test.

The 2nd patent deals with continuous infusion of Adenosine in 13 or 15 different situations (Stress Test included) where if adenosine is involved in CI, then it has to be brand Adenoscan...this patent expires in 2013 in which Teva challenged in court. Instead of fighting this, Astellas settled out of court and is allowing Teva to manufacture large vial generic Adenosine in 2011 or 2012 which can be used in Stress Test and CI situations.

In order to protect themselves, Astellas is feverishly marketing Lexiscan to position themselves with continuous revenue by having Lexiscan added to hospitals throughout the country. They are doing this by pricing it about $10 cheaper than Adenoscan 30ml vials.

Generic Adenosine would cost around $50 per stress test..where brand Adenoscan 30ml costs around $190...and Lexiscan at around $180. The pricing may vary according to GPO.

Thanks for reading.
Click to expand...
 
We use both. The vast majority is persantine (probably 90ish percent).

On a somewhat related note, how do you mix your persantine? We QS whatever the dose of persantine is to 40mL with D5W and send in a 60mL syringe. Pretty standard, or are there variations out there?
 
If you're curious to see some numbers from a nuclear pharmacy's dispensing point of view...for CY 2009, we've dispensed (to both clinics, and hospitals...though can't explain to you why some hospitals order from us):
  • Adenoscan®: 540 vials
  • Lexiscan®: 240 vials
  • Dipyridamole: 860 vials
  • Dobutamine: 160 vials
Interestingly enough, we even supply accounts with drawn up unit doses of Adenoscan. They provide us with the patient's weight...0.84 mg/kg, and voila...$$$

Ditto everything Z said regarding the patents, and as he mentioned...prices all differ based on GPO/contracts. I see a lot of hospitals make some peculiar choices when it comes to stress agents though.
 
SpirivaSunrise said:
If you're curious to see some numbers from a nuclear pharmacy's dispensing point of view...for CY 2009, we've dispensed (to both clinics, and hospitals...though can't explain to you why some hospitals order from us):
  • Adenoscan®: 540 vials
  • Lexiscan®: 240 vials
  • Dipyridamole: 860 vials
  • Dobutamine: 160 vials
Interestingly enough, we even supply accounts with drawn up unit doses of Adenoscan. They provide us with the patient's weight...0.84 mg/kg, and voila...$$$

Ditto everything Z said regarding the patents, and as he mentioned...prices all differ based on GPO/contracts. I see a lot of hospitals make some peculiar choices when it comes to stress agents though.
Click to expand...

So how is the world shortage of medical isotopes going? Will you be out of a job soon?
 
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SpirivaSunrise said:
If you're curious to see some numbers from a nuclear pharmacy's dispensing point of view...for CY 2009, we've dispensed (to both clinics, and hospitals...though can't explain to you why some hospitals order from us):
  • Adenoscan®: 540 vials
  • Lexiscan®: 240 vials
  • Dipyridamole: 860 vials
  • Dobutamine: 160 vials
Interestingly enough, we even supply accounts with drawn up unit doses of Adenoscan. They provide us with the patient's weight...0.84 mg/kg, and voila...$$$

Ditto everything Z said regarding the patents, and as he mentioned...prices all differ based on GPO/contracts. I see a lot of hospitals make some peculiar choices when it comes to stress agents though.
Click to expand...

dork..
 
MountainPharmD said:
So how is the world shortage of medical isotopes going? Will you be out of a job soon?
Click to expand...

Ehhh, past few weeks have been ok. I expect we'll have a few rough days in July.

To add insult to injury, there will be an indefinite Xe-133 gas shortage too starting next week. Cross your fingers that you won't need a VQ scan anytime soon.

And no, I won't be out of a job...I'm too good at what I do, and none of y'all want to do it! :meanie:😛
 
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StaviZFingerZ said:
Nights = when radio active stuff is mixed for early dx tests...

Skirt & Heels = Drug Repping...


MountainPharmD = needs get his head out of the gutters..


👍
Click to expand...

Not my fault when you lead me straight there!

So I was just outside mowing the lawn...I thought it got hot in Dallas?
 
MountainPharmD said:
Not my fault when you lead me straight there!

So I was just outside mowing the lawn...I thought it got hot in Dallas?
Click to expand...

nah, we have a cold spell right now. I was up early and trimmed hedges around the house this morning and I had to put on a wool turtleneck sweater and ear muffs.
 
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Praziquantel86 said:
We use both. The vast majority is persantine (probably 90ish percent).

On a somewhat related note, how do you mix your persantine? We QS whatever the dose of persantine is to 40mL with D5W and send in a 60mL syringe. Pretty standard, or are there variations out there?
Click to expand...

we put 60mg (12ml of the 50mg/10ml vials we have) in a 25ml ns bag then add an extra 8ml ns to the bag to get the concentration we need
 
SpirivaSunrise said:
So which one of you guys hijacked the Astellas trailer??
Click to expand...


I first thought it was an inside job.... trailer full of Adenoscan to force hospitals to use Lexiscan... but evidently there were other drugs involved.
 
Praziquantel86 said:
We had an Astellas rep in at work today. He brought chicken parm (along with information on Mycamine and LexiScan). The food was a lot more impressive than the talk.
Click to expand...


Those F**kers threatened to sue my hospitals.... I'm counting my days.
 
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Praziquantel86 said:
Why would Astellas want to sue your hospitals? Not enough fungemic patients with heart failure requiring stress tests?
Click to expand...

What do you think they were doing with this?

aden8773.jpg
 
Praziquantel86 said:
We had an Astellas rep in at work today. He brought chicken parm (along with information on Mycamine and LexiScan). The food was a lot more impressive than the talk.
Click to expand...
WTF? I work next door and we never got lunch. And we go through more then enough. lame
 
why would Astellas sue? Figure it out...there are enough clues on this post. Start with post #3
 
Quiksilver said:
WTF? I work next door and we never got lunch. And we go through more then enough. lame
Click to expand...

The only Astellas products that you guys would use are AmBisome and Mycamine. Are they on your formulary?

Mot that it really matters, all your complicated problems get schlepped onto us anyways. Jerks.
 
Praziquantel86 said:
You use a standard dose of persantine across the board?
Click to expand...

as far as i can tell. i've only made it one way each time i get an order for a stress test. one persantine bag and two aminophylline bags
 
Praziquantel86 said:
The only Astellas products that you guys would use are AmBisome and Mycamine. Are they on your formulary?

Mot that it really matters, all your complicated problems get schlepped onto us anyways. Jerks.
Click to expand...

Our job is to fight cancer. Thats the bigger problem. Do you guys do a lot of chemo?

We use a ton of ambisome and mycamine, they are both formulary. We also make enough tacrolimus on a daily basis, bone marrrow patients need it. It formulary in any way that tacro comes. Flomax may be on there as well.

Roche should also love use the way we go through Cellcept too
 
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