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[e-drug] Rational and economic use of Plasma Expanders?

E-DRUG: Rational and economic use of Plasma Expanders?

Dear E-Druggers,

In a country with an Essential Drugs Programme, some guidance in the rational 
use of a cost effective colloid for hypovolaemia, in a district hospital 
facility will be helpful. 

The district hospital facility does minor surgery, emergency caesarean sections 
and circumcisions. All other surgery is referred to a higher level of care. The 
district facility has opted not to use the regular plasma expander, Plasmalyte 
B (1000 mL) costing R21.43. 

The Provincial Pharmacy and Therapeutics Committee in an extended formulary 
coded Voluven i.e. poly (O-2-hydroxyethyl) starch 60G, NaCl 0.9 G/ 500ml for 
hypovolaemia and prophylaxis in prolonged surgery. The cost of the item is 
R54.72 for 500ml equating to R109.44 for 1000 mL. 

In view of needs to spread the budget for the country's priority needs and cost 
difference of R88.01 per equal volume, is there a greater benefit in using 
Voluven over other blood volume expanders? 

Your expertise and comments will be appreciated.


Mariam Cassimjee.
B Pharm. M Pharm (UKZN).
Private Pharmacy Practice Consultant
South Africa

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