Coagucheck vs InRatio

[pem]

Hi. I would like to begin testing at home, so I'm doing my due diligence here about which machine to get. I think I looked into it briefly before and thought that InRatio looked like a better fit for me, but I don't remember why.

Is there a summary of the pros and cons to each system? The home health nurses all used coagucheck machines, but their results varied from system to system more than I think my INR was actually varying (according to the lab values taken at the same time). Maybe one of them had a lemon. Anyway, just wondering what the community thinks about these brands and any others that I should be aware of.

Thanks a lot!
pem

 

[catwoman]

The two systems are just about identical in performance and operation.
I have an INRatio and have tested it against the CoaguChek in my family doctor's office. There was only 0.1 difference in values.
The CoaguChek, made by Roche, has been on the market longer than the INRatio and Roche has aggressively promoted its products to the medical profession. BTW, Roche also makes the AccuChek glucometer for diabetics.
I've been satisfied with my INRatio. I got it 3+ years ago, having started out with a ProTime 3 by ITC in November 2003.

 

[pem]

Thanks! What prompted you to switch from the ProTime 3 to the INRatio. Also, why did you choose INRatio instead of CoaguChek?

Best,
pem

 

[pem]

Thanks! What prompted you to switch from the ProTime 3 to the INRatio. Also, why did you choose INRatio instead of CoaguChek?

Best,
pem

 

[Protimenow]

I can't answer for Marsha, but I moved from the ProTime to the ProTime 3 to the InRatio.

The ProTime to InRatio move was fairly easy. The ProTime, while possibly more accurate (possibly) than InRatio or CoaguChek S or XS, requires a lot more blood than the InRatio or CoaguChek meters, and uses strips that must be refrigerated. It's a bit of a pain getting the extra blood needed for the ProTime and, again, there's the issue of refrigerating the test 'strips' (which they call cuvettes). Also, if your strips expire, the meter won't take them (the InRatio will gracefully use a strip that's up to a few months 'expired' - but quality controls built in will indicate if the strip is still good.

The InRatio just seemed to be easier to use than the ProTime or ProTime 3 -- at least, for me, it was easier. The InRatio strips don't require refrigeration unless your storage temperature exceeds 90 F (as it does every summer here).

CoaguChek XS strips also don't require refrigeration (but may have some upper temperature storage limit). I don't know what the CoaguChek XS will do with an expired strip. The CoaguChek XS may be just slightly easier to use because you can put your incised finger (and its big drop of blood) onto the side of the strip and capillary action will bring it into the strip for testing. (With my InRatio, sometimes it's not easy positioning the drop of blood onto the small dot on the strip - I sometimes use capillary tubes made for that purpose).

The InRatio 2 is supposed to give you test results more quickly than the original InRatio. It uses icons instead of text, which makes it easier to sell the meters internationally. I'm not sure if the icons make it easier to use than the text or not - I've heard both opinions.

(One thing to consider -- some facilities 'retire' their perfectly functional meters once they've been fully amortized (3-5 years) -- which may mean that InRatio and possibly CoaguChek XS meters may be available for considerably less than retail. I got my InRatio and ProTime meters on eBay -- and they've been functional and accurate. One day, perhaps, I'll also try a CoaguChek XS -- but I'm still quite satisfied with my InRatio).

Another thing -- I've had questions for Alere, which now owns InRatio, and support has been excellent. I don't know about Roche support.

One more thing -- DON'T buy a CoaguChek S. It was discontinued a few years ago, and Roche will stop supporting it very soon. You may not be able to get strips that expire after early next year. Also, the CoaguChek S was not made for home testing and quality control is not built in.

You should be happy with either the CoaguChek XS or an InRatio (or InRatio 2). All are made to accurately run tests (and all may have more deviation from lab tests the higher your INR gets).

Oh -- one more answer to 'why did you choose INRatio instead of CoaguChek?' -- in my case, the answer is simple. I was able to get an InRatio on eBay at a very good price. If I was offered a CoaguChek XS (instead of an InRatio) at the same price, I would probably have gotten that instead. Both are good meters, from good manufacturers, and the cost per test is pretty comparable.

 

[RobThatsMe]

While you are researching both of these units, I might suggest that you check to see if either of these units will correctly provide your INR if you are bridging with Lovenox.

I was told in the past that only the Coaguchek unit will provide a correct reading while bridging.
I already own an InRatio2, and had to go to the lab for testing while I was bridging.
So, I never really followed up on this. If my InRatio was able to provide correct readings while bridging, it would have saved me several weeks of going to the lab to check in INR levels.

Rob

 

[pem]

Protimenow,

This is great information - thank you! Do you think Alere will be around as long as Roche? Are they equivalent in terms of size and stability as companies?

pem

 

[pem]

While you are researching both of these units, I might suggest that you check to see if either of these units will correctly provide your INR if you are bridging with Lovenox.

I was told in the past that only the Coaguchek unit will provide a correct reading while bridging.
I already own an InRatio2, and had to go to the lab for testing while I was bridging.
So, I never really followed up on this. If my InRatio was able to provide correct readings while bridging, it would have saved me several weeks of going to the lab to check in INR levels.

Rob

Wow - that seems pretty important. Thanks, Rob - I'll look into that!
pem

 

[Protimenow]

Alere bought the InRatio from Hemosense, which developed and initially manufactured and marketed it. Alere has been involved with anticoagulation management for quite a while. I don't know the size or financials behind Alere, and doubt their equivalence (because Roche is HUGE), but am confident that the InRatio devices will be around for a LONG time. (Besides, I think there may be some federal regulations requiring availability of support products for this type of medical device -- I'm guessing that, if Alere should run into trouble, Roche may be willing to gobble them up and offer upgrades for InRatio users). I don't personally foresee any problems using an InRatio meter -- by the time a company's health is an issue, presumably there will be newer test devices -- or drugs that don't require INR testing.

I took that gamble (buying an InRatio meter) last year and am quite pleased with it. I am not worried about Alere's ongoing support.

 

[Protimenow]

Rob: Interesting information. Were you able to confirm this by running your own test while you were trusting the lab to do testing?

 

[D.C.]

Wow!! Just joined this forum and am looking at the inratio2 if I can get insurance to help. Thanks to all for the info. Will be following.

 

[catwoman]

Thanks! What prompted you to switch from the ProTime 3 to the INRatio. Also, why did you choose INRatio instead of CoaguChek?

Best,
pem

The ProTime 3 had a built-in battery, making it heavier than the INRatio; test strips had to be refrigerated; and overall, the unit was larger than the INRatio or CoaguChek.
I travel a lot on weekends and wanted to take my tester, if needed, so I wanted a smaller unit.
I went with the INRatio because (1) friends were happy with their INRatios and (2) there had been issues with CoaguChek testing strips a number of years ago. Production was halted on the strips and individuals in the U.S. up a creek for quite a few months. I think there had been 2 incidents like this. So I chose the INRatio.
Problems with the testing strips have since been resolved.

 

[RobThatsMe]

Rob: Interesting information. Were you able to confirm this by running your own test while you were trusting the lab to do testing?

Hi,

No, I didn't bother after the nurse in the lab informed me that my unit will not provide accurate readings while on Lovenox. She, and another lab person both told me that the only one that will read correctly was the Coagacek.

It was an inconvienence, but thankfully only temporary while I bridged for some monor surgery.

Rob

 

[Protimenow]

There was also a significant issue relating to cleaning the CoaguChek XS. (This may not be an issue for a home tester). The issue related to the wrong cleaning solution being used and, for some reason, this caused inaccurate test results. For personal use, there may be less risk of getting blood inside the meter and requiring cleaning -- and I'm sure Roche is more emphatic about the right way to clean this meter than it may have been originally.

Either meter is probably a good choice (although I still really like my InRatio)

 

[Bina]

PEM, I won't bore you with useless information about discontinued monitors...etc. etc.

Basically, If you buy a monitor, buy one of the 2 newest brands: INRatio2 or Coaguchek XS.
Both are very good and widely used with success and accuracy.

 

[Protimenow]

Information about discontinued meters may be boring -- but it ISN'T boring or useless to anyone who may BUY ONE or consider buying one without knowing that they're discontinued. People are still trying to sell the CoaguChek S .. and if a person buys based on price only, and doesn't know that the S is discontinued, there IS a possiblility that the boring 'useless' information would have been of value.


Pem -- you asked about predicted longevity and success of Alere. If you visit their website, you may be impressed (as I was) by how broad their business is.

Also -- I have an InRatio (the original) - I'm happy with it. Although I'd certainly consider trying an InRatio 2 (because it gives results a minute faster and has a larger screen), I don't think that the decision about which meter to buy would preclude the InRatio. (So - my recommendation would be InRatio2 (somewhat newer model), InRatio, or CoaguChek XS. I haven't used the XS, so I can't say whether I'd prefer it over the InRatio.).

 

[M C Moll]

If you are with Medicare, CoaguCheck sx is supplied without expense by Roche. They sent out a nurse for instruction and you call the INR results to Roche when testing. I had the CoaguCheck s and the new machine sx is much smaller and faster and easier to use. I used the 'old' CoaguCheck for 10 years until it was no longer supported and no test strips are available now.
Being an Oral and Maxillofacial Surgeon I had no trouble using either tester and really appreciate not having to go for periodic testing at a facility. My doctor lets me adjust the coumadin medication as needed to stay in the therapuetic range. I was told not to change my diet and adjust the coumadin as needed. When checking my results occasionally with the lab results, the values were right on.

 

[pem]

Basically, If you buy a monitor, buy one of the 2 newest brands: INRatio2 or Coaguchek XS.
Both are very good and widely used with success and accuracy.

Sounds straightforward - thanks. I'm still curious though about Rob's comment regarding bridging...

pem

 

[pem]

Information about discontinued meters may be boring -- but it ISN'T boring or useless to anyone who may BUY ONE or consider buying one without knowing that they're discontinued. People are still trying to sell the CoaguChek S .. and if a person buys based on price only, and doesn't know that the S is discontinued, there IS a possiblility that the boring 'useless' information would have been of value.

Well-taken - thanks.

Have you had any issues with bridging?

pem

 

[pem]

If you are with Medicare, CoaguCheck sx is supplied without expense by Roche. They sent out a nurse for instruction and you call the INR results to Roche when testing. I had the CoaguCheck s and the new machine sx is much smaller and faster and easier to use. I used the 'old' CoaguCheck for 10 years until it was no longer supported and no test strips are available now.
Being an Oral and Maxillofacial Surgeon I had no trouble using either tester and really appreciate not having to go for periodic testing at a facility. My doctor lets me adjust the coumadin medication as needed to stay in the therapuetic range. I was told not to change my diet and adjust the coumadin as needed. When checking my results occasionally with the lab results, the values were right on.

Thanks. I hope to get into a routine much like you describe. The adjustment formulas/decision trees look straightforward. I could write myself a little program or use an existing one for dosing adjustments. I'm not yet eligible for Medicare, but I think I will have some coverage for this.

pem