1. CBS Transfusable Products Update
NAC Meeting
April 2012
Rick Trifunov
Director, Plasma Products and Services
NAC November 2009

2. Presentation Overview
Transfusable Products Update
Distribution Data
System Outdates
Red Cells
Platelets
Pathogen Reduction Update
NAC November 2009

3. Transfusable Products Distribution Trends

4. In the first 3 Q’s of F11/12, Demand for RBC is trended back to longer term growth patterns
Anecdotal feedback received of strong first two quarters for traumas and increased transfusion triggers in cardiac surgery

5. Positive growth in 6/9 Provinces
Cindy, Jennifer – any thoughts as to why?
NAC November 2009

7. O Neg RBC trending upwards first 3Q’s of the year
O Neg RBC trending upwards first 3Q’s of the year. O Neg inventories have been drawn down in Q4 and orders cut
We have been cutting inventories by 10% over last few weeks, to protect inventory.
NAC November 2009

8. NL, PEI & NS showing largest growth over previous year
NAC November 2009

9. CMV Neg % running flat

10. Frozen Plasma demand continues to decline however we are starting to see a slow down

11. Sizeable shifts in 4 Provinces. Data anomaly or shifts in practice?
Wassup with NS?
Reductions driven by appropriate use vs. new PPPs?
NAC November 2009

13. The % of plasma orders for AB is growing
Note: CAGR over the last seven years is -2% for plasma but is 0% for AB plasma

14. Several Provinces seeing large shifts in the % of AB plasma ordered versus previous fiscal
Seeing some jumps.
NAC November 2009

15. Strong platelet growth in the first two quarters of 11/12
Anecdotal feedback attributes growth to increased use of “platelet drugs” such as Plavix, and continued decentralization of oncology care resulting in more sites inventorying platelets
NAC November 2009

16. Sizeable platelet demand growth in some Provinces
MB – what’s driving?
NAC November 2009

18. Demand for CMV Negative Platelets as a % of all platelet orders remains around 34 – 35%

19. Is NAC still considering recommending a “25% cap” on CMV Neg Supply
Order fill rate = 98%, so most are getting what they order.
CMV virus is filtered out with white cells
Testing for cmv costs money.
Most of Atlantic showing significantly different usage patterns than the rest of Canada,
NAC November 2009

20. CBS to start development work for pooled cryo in 2012/13.
The strong growth seen last year for Cryo has continued in the first 3 Q’s of the year
Anecdotal feedback of greater use in massive hemorrhage protocols
10 x 10ml doses req’d to give a decent Fibrinogen dose.
If we start to pool cryo, what dose would they expect? AB and BC will want this regardless of PPP Fibrinogen concentrate.
CBS to start development work for pooled cryo in 2012/13.
What specification would NAC members expect in the final pooled product (Fibrinogen content)?
NAC November 2009

21. Large rise in Cryo demand in New Brunswick - ? New treatment protocols
149.2%
Large rise in Cryo demand in New Brunswick - ? New treatment protocols
Need to understand why for NB?
NAC November 2009

22. Per capita demand for Cryo in NB nearing that of NL & NS

23. System Outdate Reports
Red Cells & Platelets

24. Data Limitations
The outdate data displayed in the following slides is sourced from two data systems. There are limitations to both data sets
CBS MAK Progesa System
A CBS site can supply multiple provinces, e.g. Halifax ships product to NS & PEI hospitals so CBS Halifax outdates apply to two provinces
Hospital Disposition System
Not all hospitals report so data can be months/quarters behind (see next slide)
There is no reconciliation to ensure 100% of issued products are accounted for

25. Data Limitations BC outdates not available for December 2011
Majority of Manitoba hospital data has not been reported since April 2010
CDHA data is not included for Nova Scotia due to problems with data extract from their IT system

26. Chart Options Two suggestions for reports have been suggested;
Report outdate rates as a percentage of units issued
Report outdates per 1,000 population

27. RBC Outdate Rates as a percent of issues
Outdate spikes tend to be linked to periods of high inventory, e.g. Jan to March 2010, pandemic inventory build.
Charts could be prepared as monthly trend charts.
These can be broken by Province however see limitations on slide 29

28. Platelet Outdate Rates as a percent of issues

29. Red Cell Outdates per 1,000 Population
Charts could also be provided as provincial comparators
If all provinces and territories were to be separated out we would need to assign CBS outdates to jurisdictions based on share
Our low CBS outdates might be because we can ship to some hospitals when near end date.
NAC November 2009

30. Platelet Outdates per 1,000 Population

31. Chart Preferences
Display outdates as a rate of issues or per 1,000 population?
Monthly trend charts vs. Multiple province view?
Best way to assign CBS Outdates?
Any other chart suggestions?
Note: Permission to share hospital outdate data outside of NAC needs to be obtained by PT’s
Don’t start sharing them outside of NAC.
NAC November 2009