Assessing the total costs of blood delivery to hospital oncology and haematology patients
ABSTRACT To determine direct costs associated with a blood transfusion session in two hospital settings.
The study was conducted in two United Kingdom hospital sites during April 2004. Transfusion sessions for patients receiving units of red blood cells within either haematology or oncology departments were followed using time and motion techniques to measure the direct costs. Other data were collected from the centres to calculate the cost of disposables, blood wastage and blood bank machines.
Total mean staff cost per transfusion of 2 units was 37.24 pounds sterling (9.68 pounds sterling for blood bank and 27.56 pounds sterling for ward procedures). The mean cost of disposables was 13.25 pounds sterling and the mean cost for blood products was 287.56 pounds sterling. The mean cost of wastage was 11.86 pounds sterling per transfusion. After including other derived costs, such as hospital stay, the mean cost for a transfusion of 2 units of blood was estimated to be 546.12 pounds sterling.
This study estimates the cost of an average blood transfusion of 2 units to be 546.12 pounds sterling. It should be noted that significant indirect costs, such as those incurred by patients, their carers and societal costs, have not been considered. Against the background of finite blood resources and other factors such as patient quality of life, blood transfusion may not represent the best choice for patient care. Alternative treatments should be considered.
- SourceAvailable from: Philippe Massin
[Show abstract] [Hide abstract]
- "Blood transfusion costs include the time spent by nurses to check compatibility and to administer the transfusion and the cost of storing and transporting the RBC units (546.12 British pounds for two units in a 2006 study by Agrawal et al.  "
ABSTRACT: Studies assessing fibrin sealants use during total knee replacement (TKR) have produced inconsistent results. We evaluated fibrin sealant therapy in TKR procedures performed without tourniquet and without postoperative drains. Use of a fibrin sealant during TKR decreases calculated total blood loss, thereby diminishing blood transfusion requirements and costs. We studied 62 patients with primary knee osteoarthritis who underwent TKR by the same surgeon between September 2009 and December 2010. Fibrin sealant was used only in the last 31 patients, who were compared to the first 31 patients regarding calculated total blood loss, blood transfusion rate, and mean number of red-blood-cell units used per patient. Costs were compared in the two groups. In the control group, mean total blood loss calculated using the method of Gross was 1.3±0.6 L, 48% of patients required blood transfusions, and the mean number of units per patient was 0.9±1. In the fibrin-sealant group, 29% of patients required blood transfusions and the mean number of units was 0.6±0.9. The between-group differences in favour of the fibrin-sealant group were not statistically significant. In each group, compared with patients not requiring blood transfusions, patients needing transfusions had significantly lower starting preoperative haemoglobin values and a significantly greater positive difference between the calculated total blood loss and the maximum allowable blood loss. In the test group, the cost of the 31 units of fibrin sealant was 9743€ and the cost reduction due to using 11 fewer red-blood-cell units was only 3484€. Hospital stay was not significantly shorter in any of the two groups. Blood transfusion minimisation during TKR should rely chiefly on correcting preoperative anaemia and optimizing transfusion decisions based on the difference between the total blood loss and the maximum allowable blood loss. Fibrin sealant did not significantly diminish transfusion requirements in our study. Randomised studies in larger patient populations are needed. The cost of fibrin sealant may exceed the expected cost savings in relation with decreased blood transfusion requirements. Level III (before-after therapeutic study).Orthopaedics & Traumatology Surgery & Research 03/2012; 98(2):180-5. DOI:10.1016/j.otsr.2011.10.012 · 1.17 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Objetivos: Llevar a cabo una revisión de la literatura sobre el coste de la transfusión sanguínea en España. Se evaluó información de otros países con el fin de comparar las tendencias en los costes. Métodos: Se realizó una búsqueda electrónica en dos bases de datos: PubMed y Ediciones DOYMA. Ante la escasa evidencia para España, se realizó una búsqueda manual en revistas especializadas. El horizonte de búsqueda fue desde el año 2002 al 2007. Veintiséis publicaciones cumplieron los criterios de inclusión: 6 artículos para España, 6 para Estados Unidos, 5 para Reino Unido, 2 para Francia y 1 para Suecia, Noruega, Holanda, Bélgica, Grecia y Canadá. Se incluyó dentro del estudio una revisión de la literatura sobre el coste del concentrado de hematíes (CH) para el Reino Unido, Estados Unidos y Canadá. Resultados: De la revisión para España se estimó que el coste de un CH ha aumentado en un 52,8% de 2001 a 2003; considerando el coste de transfundir un CH el coste aumenta un 29,9% (2003–2006). En comparación con otros países, el coste de un CH en los Estados Unidos ha aumentado un 11,73% (2001–2003). En el Reino Unido ha aumentado un 34,11% (2002–2005), y en Francia ha aumentado un 9,05% (2000–2003). Conclusión: La utilización de una moneda común (€) y los precios constantes al año 2007 permiten realizar una fácil comparación en el tiempo y entre países. El coste de un CH en España se estimó en 150 € por unidad de CH y en 350 € por concentrado transfundido.Pharmacoeconomics - Spanish Research Articles 04/2013; 6(2). DOI:10.1007/BF03320851
- [Show abstract] [Hide abstract]
ABSTRACT: Healthcare organizations must evaluate the cost effectiveness of the alternative therapies that are available to treat anemia and improve quality of life (QoL) of patients with cancer, that is, erythropoietic protein therapy and blood transfusion. Pharmacoeconomic studies that evaluated the cost of not treating anemia or treating with transfusion or erythropoietic protein therapy were reviewed and compared. Studies of individual erythropoietic proteins (epoetin alfa, epoetin beta or darbepoetin alfa) were also assessed. As no prospective trials have compared the erythropoietic proteins, retrospective studies and the results of separate trials were analyzed. The database searched for this review was PubMed (open date to August 2006). Recent conference abstracts were also searched (2003-July 2006). There is a high cost associated with anemia in cancer patients. Treatment of anemia is likely to lead to increased hemoglobin (Hb) levels and improved QoL as principal outcomes. Therefore, in assessing erythropoietic protein versus transfusion, it is more appropriate to use Hb or QoL as endpoint rather than quality adjusted life year. Studies with the former approach showed that erythropoietic protein therapy is more cost effective than transfusion. Also, its cost effectiveness should be improved with the use of evidence-based guidelines for patient selection and more tailored utilization. Increasing evidence suggests there might be differences among the erythropoietic proteins in terms of response rate, speed of response, and need for dose escalation. Significant costs are incurred when anemia in cancer is not treated. Erythropoietic protein therapy is more cost effective than blood transfusion for the treatment of cancer-related anemia. Transfusion should be reserved for patients with poor responses to erythropoietic protein or for the emergency setting, when rapid improvement in Hb is required.Current Medical Research and Opinion 03/2007; 23(2):357-68. DOI:10.1185/030079906X167282 · 2.37 Impact Factor