Using Lean Tools to Reduce Missed Charges for Testing and Improve Productivity of Daratumumab Testing

Document Type

Conference Proceeding

Publication Date

11-12-2025

Publication Title

Am J Clin Pathol

Keywords

daratumumab, immunoglobulin kappa chain, monoclonal antibody, paraprotein, adult, aged, case report, clinical article, conference abstract, controlled study, human, plasma cell dyscrasia, root cause analysis, simulation, special situation for pharmacovigilance, very elderly

Abstract

Introduction/Objective: Daratumumab (Dara) is a human therapeutic IgG kappa monoclonal antibody used in the treatment of plasma cell dyscrasia. In IFIX testing, this antibody falsely simulates an endogenous IgG Kappa paraprotein. We perform a Hydrashift IFIX when we detect a small IgG kappa monoclonal protein present in the mid to slow gamma region and is known to be receiving Dara and when there is a small IgG kappa monoclonal protein migrating in the same gamma region as Dara. Manual Dara ordering in the lab information system is time-consuming and can lead to missed charges. Methods/Case Report: We sought to eliminate missed charges for Dara testing and decrease time for Dara testing. Root cause analysis led to a reflexed automated charge for Dara that should also allow extra capacity and more flexible time for running the test at a time our volume is increasing. Results: The charge for Anti-daratumumab testing is $134. With the total number of Dara cases resulted in 2024 was 8760, the total charges for Dara testing were significant, at $1,173,840 in 2024. We decreased to zero our missed charges and reduced overall time for Dara testing. Conclusion: We created an automatic charge process for Dara, reducing missed charges and saving time.

Volume

164

First Page

S23

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