• Christopher A Jones, Katrina Ducis, Jeffrey Petrozzino, Eric Clark, Mark K Fung, Christian Peters, Indra Neil Sarkar, Emilia Krol, Brina Pochal, Amanda Boutrus, Peter Weimersheimer, and Kalev Freeman.
• a 1 Global Health Economics Unit of the Center for Clinical and Translational Science, University of Vermont, College of Medicine, Burlington, VT, USA.
• Expert Rev Pharmacoecon Outcomes Res. 2016 Jan 1; 16 (1): 135-9.

IntroductionFresh frozen plasma (FFP) is a frequently used human blood product to reverse the effects of vitamin K antagonists. While FFP is relatively economical, its large fluid volume can lead to hospitalization complications, therefore increasing the overall cost of use.Materials & MethodsA recently published article by Sarode et al., in Circulation, described the rate of volume overload associated with FFP use for reversal of vitamin K antagonists. This condition, described as transfusion-associated circulatory overload, has a defined rate of intensive care admission, which also has a well-reported average cost. The additional monetary value of intensive care unit admission and caring for fluid overload is then compared to the cost of another product, four-factor prothrombin complex concentrates, which does not, as per the Sarode paper, result in fluid overload.ResultsThe increased costs attributed to FFP-associated fluid overload for vitamin K antagonist reversal partly defrays the increased upfront cost of four-factor prothrombin complex concentrates.DiscussionFFP is commonly used to acutely reverse the effects of vitamin K antagonists. However, its use requires significant time for infusion, may lead to fluid overload, and is not fully effective in compete anticoagulation reversal. One alternative therapy for anticoagulant reversal is use of prothrombin complex concentrates, which are rapidly infused, are not associated with fluid overload, and are effective in complete reversal of coagulation measurements. This should be considered for patients with acute bleeding emergencies.

18 keywords...

hide…