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The economics of blood: Gift of life or a commodity?

Published online by Cambridge University Press:  09 August 2006

Panos Kanavos ,
John Yfantopoulos ,
Christina Vandoros  and
Costantina Politis
Panos Kanavos
Affiliation:
LSE Health, London School of Economics
John Yfantopoulos
Affiliation:
University of Athens and National Centre for Social Research
Christina Vandoros
Affiliation:
Janssen-Cilag and National School of Public Health
Costantina Politis
Affiliation:
Athens General Hospital “G. Gennimatas”
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Abstract

Objectives: To calculate the costs of blood collection, testing, storage, and transfusion in Greece.

Methods: Costing information was collected from two large public hospitals, in Athens and Crete, that also act as blood banks. Given that private health care accounts for 40 percent of total health spending, the same costs were also considered in a private setting by collecting key reagent cost data from a leading private hospital in Athens. Mainly direct costs were considered (advertising campaigns, personnel, storage and maintenance, reagent costs, transportation costs from blood bank to end-use hospitals, and cross-matching and transfusion costs in receiving hospitals) and some indirect costs (opportunity cost of blood donorship).

Results: Captive donorship accounts for over 50 percent of the national blood supply. A unit of blood transfused would cost between €294.83 and €339.83 in public hospitals and could reach €413.93 in a private facility. This figure may be an underestimate, as it excludes opportunity costs of blood transfusion for patients and the healthcare system.

Conclusions: Blood has a significant cost to the health system. Policy makers and practitioners should encourage its rational use, build on current policies to further improve collection and distribution, encourage further volunteer donorship in Greece, and also consider alternatives to blood where the possibility exists.

Keywords

BloodBlood transfusionCost of bloodPublic goodGiftHemotherapyDirect and indirect costsHealth policy
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 3 , July 2006 , pp. 338 - 343
Copyright
© 2006 Cambridge University Press

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References

Ademokun A, Kaznica S, Deas S. 2005 Home blood transfusion: A necessary service. Transfus Med. 15: 219– 222.Google Scholar
Amin M, Fergusson D, Wilson K, et al. 2004 The societal unit cost of allogenic red blood cells ad red blood cell transfusion in Canada. Transfusion. 44: 1479– 1486.Google Scholar
Bank of Greece. 2003. Bulletin of economic activity. Athens: Bank of Greece;
Beal RW, van Ahen WG. 1992 Gift or good? A contemporary examination of the voluntary and commercial aspects of blood donation. Vox Sang. 63: 1– 5.Google Scholar
Blumberg N, Kirkley SA, Heal JM. 1996 A cost analysis of autologous and alogeneic blood transfusions in hip replacement therapy. Am J Surg. 171: 324– 330.Google Scholar
Cooper MM, Culyer AJ. 1968. The price of blood. Hobart Paper 41. London: Institute of Economic Affairs;
Coyle D, Lee KM, Fergusson DA, Laupacis A. 1999 Economic analysis of erythropoietin use in orthopaedic surgery. Transfus Med. 9: 21– 30.Google Scholar
Coyle D, Lee K, Laupacis A, Fergusson D. Economic analysis of erythropoetin use in surgery. Report submitted to CCOHTA, 18 November 1997, Ottawa.
Cremieux P-Y, Barrett B, Anderson K, Slavin MB. 2000 Cost of outpatient blood transfusion in cancer patients. J Clin Oncol. 18: 2755– 2761.Google Scholar
Diekamp U. 1994 [Comparison of production costs of allogeneic and autologous blood preservation.] Beitr Infusionsther Transfusionsmed. 32: 505– 511.Google Scholar
Dixon S, James V, Hind D, Currie CJ. 2005 Economic analysis of the implementation of autologous transfusion technologies throughout England. Int J Technol Assess Health Care. 21: 234– 239.Google Scholar
Drummond MF. 1996. Principles of economic appraisal in health care. Oxford: Oxford Medical Publications;
Drummond MF, Davies L. 1990 AIDS. The challenge for economic analysis. University of Birmingham,
Duffy G, Tolley K. 1997 Cost analysis of autologous blood transfusion, using cell salvage, compared with allogeneic blood transfusion. Transfus Med. 7: 189– 196.Google Scholar
Dusheiko GM, Roberts JA. 1995 Treatment of chronic type B and C hepatitis with interferon alfa: An economic appraisal. Hepatology. 22: 1863– 1873.Google Scholar
Forbes JM, Anderson MD, Anderson GF, et al. 1991 Blood transfusion costs: A multi-centre study. Transfusion. 31: 318– 323.Google Scholar
Gibis B. 1997 Leukodepletion—an investigation into the techniques used, their effectiveness and costs. Canadian Coordinating Office of Health Technology Assessment (CCOHTA). Draft report,
Glengård AH, Persson U, Söderman C. 2005 Costs associated with blood transfusions in Sweden—the societal cost of autologous, allogenic and peri-operative RBC transfusion. Transfus Med. 15: 295– 306.Google Scholar
Gold M, Gafni A, Nelligan P, Millson P. 1997 Needle exchange programs: An economic evaluation of a local experience. CMAJ. 157: 255– 262.Google Scholar
Goodman C, Chan S, Collins P, et al. 2003 Ensuring blood safety and availability in the US: Technological advances, costs, and challenges to payment—final report. Transfusion. 43 (Suppl 8): 3S– 46S.Google Scholar
Goodnough LT. 2005 Autologous blood donation. Anesthesiol Clin North America. 23: 263– 270.Google Scholar
Guest JF, Munro V, Cookson RF. 1998 The annual cost of blood transfusions in the UK. Clin Lab Haematol 20: 111– 118.Google Scholar
Hellenic Coordinating Haemovigilance Centre (SKAE). 2003 Epidemiological surveillance on infections in blood donors (2000-2001). Edition of Hellenic Centre for Infectious Diseases Control (KEEL). Athens, January.
Hess JR, Zimrin AB. 2005 Massive blood transfusion for trauma. Curr Opin Hematol. 12: 488– 492.Google Scholar
Jarvis LM, Dow BC, Cleland A, et al. 2005 Detection of HCV and HIV-1 antibody negative infections in Scottish and Northern Ireland blood donations by nucleic acid amplification testing. Vox Sang. 89: 128– 134.Google Scholar
Karkouti K, McCluskey SA, Evans L, et al. 2005 Erythropoietin is an effective clinical modality for reducing RBC transfusion in joint surgery. Can J Anaesth. 52: 262– 268.Google Scholar
Kyriopoulos JE, Michail-Merianou V, Geitona M. 1995 Blood transfusion economics in Greece. Transfus Clin Biol. 2: 387– 394.Google Scholar
Linden JV, Kaplan HS. 1994 Transfusion errors: Causes and effects. Transfus Med Rev. 9: 169– 183.Google Scholar
Loudon B, Smith MP. 2005 Recombinant factor VIIa as an adjunctive therapy for patients requiring large volume transfusion: A pharmacoeconomic evaluation. Intern Med J. 35: 463– 467.Google Scholar
MacLaren R, Sullivan PW. 2005 Cost-effectiveness of recombinant human erythropoietin for reducing red blood cells transfusions in critically ill patients. Value Health. 8: 105– 116.Google Scholar
Michail-Merianou V. 1996. Introduction to the management of haemotherapy units [in Greek]. Athens: E.M. Papadakis;
Noel L, Debeir J, Cosson A. 1998 The French haemovigilance system. Vox Sang. 74 (Suppl 2): 441– 445.Google Scholar
Official Journal of the European Union. 1989 Council Directive 89/381/EEC (special provisions for medicinal products derived from human blood or human plasma). Official Journal. L181: 44– 48.
Official Journal of the European Union. 2003 Directive 2002/98/EC of the European Parliament and of the Council (setting standards of quality and safety for the collection, testing, processing, storage and distribution of human blood). Official Journal. L33: 30– 38.
Organisation for Economic Cooperation and Development (OECD). 1987 OECD financing and delivering health care. A comparative analysis of OECD countries, Paris: 51.
Ortega A, Dranitsaris G, Puodziunas A. 1998 A clinical and economic evaluation of red blood cell transfusions in patients receiving cancer chemotherapy. Int J Technol Assess Health Care. 14: 788– 798.Google Scholar
Pitocco C, Sexton TR. 2005 Blood donor and blood collection: Alleviating blood shortages in a resource-constrained environment. Transfusion. 45: 1118– 1126.Google Scholar
Politis C. 2002 Present and future problems transfusion medicine in Greece. In: Rossi U, Aprilir G, eds. Present and future problems of transfusion medicine in South-Eastern Europe. Milano: Edizioni SIMTI; 61– 68.
Politis C. 2001 Analysis and report of Greek regulations on transfusion medicine. Proceedings of the European School of Transfusion Medicine (ESTM), 25-28 October, Sarajevo. pp 241– 257.
Politis C, Kavallierou P, Damaskos P, et al. 2003 Surveillance of infections in blood transfusion: A managerial tool to improve safety of Blood. Presented at the VIII European Congress of the international Society of Blood Transfusion, Istanbul, July 5-9,
Politis C, Tsiroyianni P, Vagena D, et al. 2002 Migrant blood donors: Ethical and safety aspects. Presented at the 27th Congress of the International Society of Blood Transfusion. Vancouver, British Columbia, August 24-29,
Politis C, Yfantopoulos J. 1993. Blood transfusion and the challenge of AIDS in Greece: Medical and economic aspects. Athens: Beta Medical Arts;
Rouger P. 2004 Transfusion medicine in Europe. Transfus Clin Biol. 11: 11– 14.Google Scholar
Sailly JC, Lebrun T, Coudeville L. 1997 Cost-effective approach to the screening of HIV, HBV, HCV, and HTLV in blood donors in France. Rev Epidemiol Sante Publique. 45: 131– 141.Google Scholar
Schreiber GB, Busch MP, Kleinman SH, et al, for the retrovirus epidemiology study. 1996 The risk of transfusion-transmitted viral infections. N Engl J Med. 334: 1685– 1690.Google Scholar
Sonnenberg FA, Nizam R, Gregory P, et al. 1996 The cost-effectiveness of autologous blood donation revisited: Implications of an increased risk of bacterial infection with allogenic transfusion. Paper presented at the Conference of the Society of Medical Decision Making, Toronto,
Titmuss RM. 1971. The gift relationship: From human blood to social policy. London: Allen & Unwin;
Tretiak R, Laupacis A, Riviere M, et al. 1996 Cost of allogeneic and autologous blood transfusion in Canada: Canadian cost of transfusion study group. CMAJ. 154: 1501– 1508.Google Scholar
United Kingdom National Blood Service (NBS). 2004 Available at: http://www.blood.co.uk. Accessed 8 November.
Van der Poel CL, Seifried E, Schaasberg WP. 2002 Paying for blood donations: Still a risk? Vox Sang. 83: 285– 293.Google Scholar
Varney SJ, Guest JF. 2003 The annual cost of blood transfusions in the UK. Transfus Med. 13: 205– 218.Google Scholar
Walker PH. 1987 Special report: Transfusion risks. Am J Clin Pathol. 88: 374– 378.Google Scholar
Woronoff-Lemsi MC, Arveux P, Limat S, et al. 1997 Cost comparative study of autologous peripheral blood progenitor cells (PBPC) and bone marrow (ABM) transplantations for non-Hodgkin's lymphoma patients. Bone Marrow Transplant. 20: 975– 982.Google Scholar