INRatio strips from different lots

[chaconne]

I recently acquired a new box of 48 INRatio2 strips from Amazon.com. I noticed that these are "new improved with wider sample area". When I compared the old lot with the new in a blood test, the new read an INR of 0.8-0.9 higher. I trusted the old lot since I had 6 tests that were within 0.1 of the lab (including a test last week). Now I don't know what to do. Anyone else have changes in readings from lot to lot?

 

[chaconne]

Nice! I just called Alere to ask them about my strips. They said I wasn't supposed to be getting strips through Amazon and that it was illegal. They said they couldn't verify the quality of my strips from an unauthorized seller and tried to get my name. Boy, this is the last time I call them! This also has shaken my faith in home monitoring.

 

[newmitral]

I just ordered a box of 12 of the new design strips (from a Ebay seller) a few days ago. I expect delivery this week sometime, and will do a comparison test using both the old and new test strips this coming Saturday. I'll post back to let you know what sort of difference I see. I have two different Inratio2 meters, so I may do a test with each type of strip in both meters (4 tests in total), if my fingers hold out. One of my 2 meters is my "official" Alere meter, and one set of test strips (the old style) is supplied by them. The other meter is a meter I purchased outside the insurance system, using test strips also purchased outside the insurance system.

I have several tests comparing Inratio2 measurements with lab blood draw tests in the past year, and they have generally been within +/- 0.2 of each other so far.
My INR varies quite a bit, so a few tenths difference doesn't concern me, but an additional error of 0.8 would be worrisome.

 

[dick0236]

In mid October I received a new batch of 24 INRatio strips from a supplier on ebay. They have an expiration date of 05/2014. They are testing about the same as my earlier strips and recently I checked my new batch(3.2) against my docs Coaguchek XS(3.3). I have purchased from a couple of different suppliers on Ebay since I bought a meter last fall and have not had any problems. I buy in 24 strip lots to help assure I don't get caught with many expired or defective strips.

PS: I just went on line to ebay and it appears my new batch is the "old style" strips. I'll have to wait until next spring to see if I have a problem with the new design.....but thanks for the "heads up" regarding a potential strip problem.

I would run a test with the new strips against a lab test. I have had significant swings of +/- .6 to .8 in INR for no apparent reason.....it happens, although not often. You might also stick your spouse or a good friend and see if they test +/- 1.0.

 

[RobThatsMe]

The "new improved" test strips from Alere, (according to them), are not to be used with the earlier InRatio testing monitor. They are only supposed to be used with the newer InRatio II monitor. I was made aware of this issue from another valve replacement site. I would suggest that you call Alere and inquire about this issue.

Rob

 

[Protimenow]

Alere tech support, a year or two ago, was quite good. They may have gotten new management, or something, in the last year because they seem to have become more defensive and less helpful. In the past, I would call with a question, and they would often send a batch of strips (6 or 12). Now, they don't send strips, even if there are concerns about a bad lot or other errors. From what's been written here, they're disavowing any responsibility for strips that were sold on Amazon (and probably on eBay), I'm assuming that strips sold via these channels are suspect, even if the seller is an authorized vendor.

I've got a year or more worth of InRatio strips - and I'm not using them. I no longer trust the meter or strips (and I got the meter directly from Alere).

 

[chaconne]

I've got a year or more worth of InRatio strips - and I'm not using them. I no longer trust the meter or strips (and I got the meter directly from Alere).

If you're interested in selling some of those strips, let me know. I'd be willing to give them a try. Are they expired yet?

 

[newmitral]

As promised in my earlier post, I did a test this morning using both the old and new design test strips, and using both my "official" Alere provided INRatio2 meter and my Ebay purchased INRatio2 meter. The results are as follows:

INR= 2.9 using "Official" INRatio2 Meter using Old Design Test Strip.
INR= 2.7 using "Official" INRatio2 Meter using New Design Test Strip.
INR= 2.8 using "Ebay" INRatio2 Meter using Old Design Test Strip.
INR= 2.9 using "Ebay" INRatio2 Meter using New Design Test Strip.

The same lot of Old design test strips was used in both meters. The same lot of New design test strips was used in both meters.
A different finger was used for each of the 4 tests.

My conclusions from this test are that for my lots of test strips and my two meters:
- Both new and old designs of test strips yield acceptably similar test results
- Both my two meters agree to within acceptable limits

As I have said before, my INRatio2 meters have been generally giving me agreement with lab draw blood tests to within +/-0.2 in INR.

So, based on my own test, I don't think there is anything fundamentally wrong with the new improved wider sample area design test strips, and I do not see the 0.8 difference noted by "chaconne".

Nevertheless, I would be interested in hearing if anyone else performs a similar test comparison with the new design test strips and is willing to post their results.

 

[RobThatsMe]

As promised in my earlier post, I did a test this morning using both the old and new design test strips, and using both my "official" Alere provided INRatio2 meter and my Ebay purchased INRatio2 meter. The results are as follows:

INR= 2.9 using "Official" INRatio2 Meter using Old Design Test Strip.
INR= 2.7 using "Official" INRatio2 Meter using New Design Test Strip.
INR= 2.8 using "Ebay" INRatio2 Meter using Old Design Test Strip.
INR= 2.9 using "Ebay" INRatio2 Meter using New Design Test Strip.

The same lot of Old design test strips was used in both meters. The same lot of New design test strips was used in both meters.
A different finger was used for each of the 4 tests.

My conclusions from this test are that for my lots of test strips and my two meters:
- Both new and old designs of test strips yield acceptably similar test results
- Both my two meters agree to within acceptable limits

As I have said before, my INRatio2 meters have been generally giving me agreement with lab draw blood tests to within +/-0.2 in INR.

So, based on my own test, I don't think there is anything fundamentally wrong with the new improved wider sample area design test strips, and I do not see the 0.8 difference noted by "chaconne".

Nevertheless, I would be interested in hearing if anyone else performs a similar test comparison with the new design test strips and is willing to post their results.

Great info and test results.
These new strips, according to Alere, are NOT to be used with the older original InRatio Monitor. (according to Alere)
They WILL WORK with the newer InRatio II monitor.
Anyone with an older unit, I would suggest you contact Alere for additional info.
Several have tested on the older units, and they have been showing similar results, that being said, the company does not recommend using them with the older InRatio monitor.

 

[dick0236]

My conclusions from this test are that for my lots of test strips and my two meters:
- Both new and old designs of test strips yield acceptably similar test results
- Both my two meters agree to within acceptable limits

As I have said before, my INRatio2 meters have been generally giving me agreement with lab draw blood tests to within +/-0.2 in INR.

So, based on my own test, I don't think there is anything fundamentally wrong with the new improved wider sample area design test strips, and I do not see the 0.8 difference noted by "chaconne".

Nevertheless, I would be interested in hearing if anyone else performs a similar test comparison with the new design test strips and is willing to post their results.

Thanks for doing this little study. I have an INRatio2, but am still using the older style strips(until next spring). Good to know that I should experience little problem with the new design. I have been checking my INRatio with my docs Coaguchec XS monthly and have found both meters report +/-0.2 with each other and I am comfortable and trusting with my INRatio2.

 

[Protimenow]

It's certainly possible for a lot of strips to somehow get past quality control and become available. Last year, I reported a problem with a lot of ProTime test strips that was giving me results that were widely different from results on other meters (and the lab). I reported this to the manufacturer who eventually issued a recall on the bad strips and replaced them with newer, 5 channel strips.

It is possible (though probably not likely) that a box of strips purchased on Amazon or eBay may not have been stored properly -- perhaps they were locked in the glove box in a hot car or something -- and were then sold. The mistreatment during storage could, possibly, have damaged the strips.

The lack of control of strip storage and handling should be somewhat troublesome to the strip manufacturers, on whom any error will probably be blamed.

As far as it being ILLEGAL to get strips from a gray market source, I have my doubts about this.

When buying any strips, try to get a return policy from the vendor. It isn't a bad idea to compare the results to a lab or to other strips of assumed accuracy, as Newmitral has done).

 

[chaconne]

Newmitral,

Thanks for doing these tests! I'm glad to know that they can work. I suppose I just happened to get a bad lot. I sent them back to Amazon and will likely try some from Ebay - just a 12 or 24 pack.

Protimenow: Did you get my last PM about purchasing some of your strips?

 

[chaconne]

I just got a new lot of 24 strips from ebay for $92. These are the new improved type. I did a blood test this morning and then went to the lab an hour later for a test. The InRatio2 reported 2.9 and the lab reported 2.8. It seems that the new strips are fine. Thanks for all of your input and testing to help confirm that the new type of strips work as well or better than the old.

 

[bocco]

Other than cost, why not just order the strips from Alere?

 

[chaconne]

I doubt Alere would agree to sell me strips without being part of some contract or service, which I would not be able to do with my current insurance.

 

[Jamey T]

I recently acquired a new box of 48 INRatio2 strips from Amazon.com. I noticed that these are "new improved with wider sample area". When I compared the old lot with the new in a blood test, the new read an INR of 0.8-0.9 higher. I trusted the old lot since I had 6 tests that were within 0.1 of the lab (including a test last week). Now I don't know what to do. Anyone else have changes in readings from lot to lot?

When I have gotten a new batch, I check the last two of the old batch against two with the new batch and follow up with blood draws. I do this to give me an idea of where my INR will be. I have kept track of every INR reading I have gotten since my surgery, so if I think about it I will look the numbers up and post them. I have noted differences between lots, and I just keep it in mind when I do my weekly test and do my dosage adjustment. I get boxes of 48 strips from eBay and I pay out of pocket, so I use them as I want.

One thing I have found, the spreadsheet that was done regarding the InRatio error seems to be VERY close to the results I get between the meter and the blood draws..