Rhophylac vs. Rhogam

[melvolny]

I need your help! I had a distributor call me a couple months ago offering Rhophylac at a much cheaper price (than Ortho Rhogam) and a promise of better insurance reimbursement. From what I can tell it looks like exactly the same as Orhto's Rhogam.

I had never heard of Rhophylac so I started calling around (actually I delegated that part) and found only one area hospital using it.

Can you let me know what you use and where you are from? Happy with it or not or no feeling one way or the other?? I want to present something to my medical director.

Thanks for being there.

Melissa

McHenry, Il

[shelleyk482]

The last facility I was at (Methodist Hospital, San Antonio, TX), we changed to Rhophylac probably 3 1/2 yrs ago. The nursing staff liked the ability to decide at bedside whether to give it IM or IV. The Ortho rep. came to me about a year after we made the switch and made some noise about the 1/2 life of Rhophylac being less than the 1/2 life of Rhogam so I did a retrospective study (6 months for each product) looking at the number of our prenatal patients who came back positive anti-D at delivery. I also looked at the mean time between prenatal injection and delivery anti-D. I found no difference between the 2 products; I'll admit is was not a "scientific" study, it was just a simple QA assessment but the pathologist and laboratory administration were comfortable with the results.

The facility that I'm at now is pretty well stocked (maybe a year worth) with Rhogam but as we start going through the stock, I will be looking at changing to Rhophylac here also. Paying a lower cost, for an equivalent product that also has flexibility in the route of administration, just makes good sense to me.

[BSIPHERD]

The last facility I was at (Methodist Hospital, San Antonio, TX), we changed to Rhophylac probably 3 1/2 yrs ago. The nursing staff liked the ability to decide at bedside whether to give it IM or IV. The Ortho rep. came to me about a year after we made the switch and made some noise about the 1/2 life of Rhophylac being less than the 1/2 life of Rhogam so I did a retrospective study (6 months for each product) looking at the number of our prenatal patients who came back positive anti-D at delivery. I also looked at the mean time between prenatal injection and delivery anti-D. I found no difference between the 2 products; I'll admit is was not a "scientific" study, it was just a simple QA assessment but the pathologist and laboratory administration were comfortable with the results.

The facility that I'm at now is pretty well stocked (maybe a year worth) with Rhogam but as we start going through the stock, I will be looking at changing to Rhophylac here also. Paying a lower cost, for an equivalent product that also has flexibility in the route of administration, just makes good sense to me.

We also switched to Rhophylac. One of our reasons was patient satisfaction. I'm told by people who have received IM RhIG that it isn't a pleasant experience. If you can give it IV, it makes patients happy!

[tbostock]

We also use Rhophylac exclusively. It is much cheaper. The Ortho rep has told me that it is not as high quality as Rhogam, but as shelleyk482 says above, we haven't seen any clinical difference.

[Sheila]

Our last BB director, who left a year ago, was a big proponent of Rhophylac and switched our hospital and the university hospital across the street to it. We use very little here, but at University they use a high volume and they are happy with Rhophylac.

[heathervaught]

After I deliver, I would rather get my Rh immune globulin through my IV line which is already in place rather than taking it IM...I will have already been poked and prodded enough (and had enough other things in places that I would rather not have them) -- one less needle stuck in my rear end is a good thing!!!

[clmergen]

We also use Rhophylac exclusively. I especially like the IV part after once issuing 5 vials of Rhogam for a large fetal maternal bleed. I felt bad for that brand new mom and all the injections she was about to get.

We also have an agreement with the pharmacy for ITP patients. We give the first dose using Rhophylac and they order in WinRho for future dosing. Pharmacy was expiring WinRho on the shelf and we always have Rhophylac on the shelf.

[BloodBank]

We have active pre-natal clinic and L&D department in Chicago (500 beds hospital) and settelite clinics. Our usage is approx. 30 Rhogam per month. We have been using Rhophylac for last 3 years. It can be injected IV or IM and it is working just fine at cheaper price for us.

[L106]

Thanks for this thread, Melvolny. Since our Pharmacy Department handles our Rh-Immune Globulin, I've been "out of the loop" for several years. I am familiar with WinRho, but had not heard about Rhophylac until these discussions.

OK, it appears that everyone who has posted in this thread has said only favorable comments. If there are any negative comments about Rhophylac, please speak up now (or forever hold your peace, as the saying goes.) Seriously, I would like to hear all the pros and cons before I approach our Director of Pharmacy. Thanks, everyone!

[Mary**]

:confused:An Ortho rep once said that if the doctor ordered Rhogam, you would have to have his/her permission to "substitute" another brand.

I wonder if there was a policy stating that the substitute was routinely used in the hospital, if that would be acceptable.

[L106]

Mary**,

I think that rep is acting like a rep. Seems to me that the OB/GYN Medical Committee (and/or the Medical Staff......however your institution does it) would be responsible for approving a policy such as:

"Physician orders for Rh prophylaxis (alias "Rh-Immune Globulin", alias "Rhogam", etc.) shall routinely be filled by the product "XYZ" from the company "ABC". (Or some type of similar statement.)

What do some of you think?

[SMW]

To Mary--

It could depend on what's on your hospital's formulary. Docs order name brand products/drugs all the time and the pharmacies routinely supply an equivalent drug/product based on the formulary list.

[Mary**]

Sounds good to me. Thanks.

[Mary**]

Thanks.

[Mary**]

Who makes /distributes it?

[BloodBank]

CSL Behring

[BloodBank]

CSL Behring

1020 First Ave.

King of Prussia, PA 19406-0901

Tel 888-841-2444

[L106]

To Mary--

It could depend on what's on your hospital's formulary. Docs order name brand products/drugs all the time and the pharmacies routinely supply an equivalent drug/product based on the formulary list.

SMW,

You explained that much better than I did. That was exactly what I was trying to say. Thanks!

L106

[Mary**]

Thanks.

[Mary**]

CSL quoted me $1.25 less than Rhogam! The only advantage is IM or IV.

[Franklyn]

We switched to Rhophylac just recently. Our major reason was cost reduction. Ortho raised their prices, changed their pricing scheme and bowed out of all the purchasing groups which had the net effect of raising the cost even more. Oddly enough, our Pharmacy brought up the idea of a switch to reduce confusion and get the 30mcg dose out of the Pharmacy and into the blood bank (out of their hair). We have seen no real difference in the products other than what has already been mentioned.

Ortho is going to price and "non-innovate" themselves out of business at this rate...

[kmh76]

Our Blood bank has been using Rhophylac for 5 years. We switched from Ortho Rhogam as it was just too expensive. The physicians like Rhophylac as it can be given IV if needed. We are in Northeastern Pa.

[Kimster]

I have had the Ortho rep also bring up half life and the Ob doc ordering scenario. The issue with half-life is Ortho did their study on Rh-negative males. CSL Behring did the Rhophylac study with Rh negative pregnant females. It's apples and oranges, can't be compared. I asked the Ortho rep to explain what half life is, didn't have a clue. As far as the docs orders just substitute the pre-written orders that I know most hospitals use to Rh Immune Globulin doesn't matter what is on the shelf then. We probably shouldn't have been using "Rhogam" all these years anyway.

[Beth2011]

We have been offered similar pricing for all three Rho D products?

How much difference have you been seeing?

Perhaps we are using a different distributor?

[AMcCord]

The pricing I was offered for Rhophylac was minimally different from RhoGAM, but I was still interested because of the option of giving it IV. Then I talked to OB and discovered that they pull their IVs on OB patients at about 3-4 hours post-delivery. Our patients rarely get their RhoGAM that soon. We haven't had to give more than 2 vials of RhoGAM to anyone in all the many years I've worked here. SO.....my rationale for switching has kind of run into a wall for now.