Premium
The cost of blood: a study of the total cost of red blood cell transfusion in patients with β‐thalassemia using time‐driven activity‐based costing
Author(s) -
McQuilten Zoe K.,
Higgins Alisa M.,
Burns Kelly,
Chunilal Sanjeev,
Dunstan Terri,
Haysom Helen E.,
Kaplan Zane,
Rushford Kylie,
Saxby Karinna,
Tahiri Renas,
Waters Neil,
Wood Erica M.
Publication year - 2019
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.15558
Subject(s) - medicine , activity based costing , unit cost , blood transfusion , emergency medicine , procurement , blood product , thalassemia , medical emergency , surgery , business , accounting , marketing , economics , microeconomics
BACKGROUND To accurately quantify the costs of care for patients with transfusion‐dependent thalassemia (TDT), and to evaluate cost‐effectiveness of new treatments, data are required on costs of regular red blood cell (RBC) transfusions. However, no previous studies have evaluated the costs of RBC transfusion specifically in chronically transfused patients. METHODS AND MATERIALS We performed a time‐driven activity‐based costing (TDABC) study using a health care provider perspective. This was performed over a 1‐month period, capturing every step of the transfusion pathway for patients with TDT at a designated provider of specialist thalassemia services in Australia. Detailed process maps were developed to outline treatments and processes directly related to transfusion. For each process map, detailed data collection, including timing of activities, was performed multiple times to account for variation in practice. Costs associated with RBC transfusion were broken down into fixed, process, and RBC procurement costs. RESULTS The total per‐unit cost was US$695.59 (95% confidence interval, US$694.45‐US$696.73). Approximately 40% of cost was for procurement of the RBC unit, with process costs accounting for 55%. The single largest contributor to process costs was attributed to iron chelation medication (approximately 80%). In sensitivity analyses, seniority of staff, time to perform processes, and probabilities of different processes occurring did not substantially influence the RBC transfusion cost; however the number of RBC units per transfusion episode did impact the overall cost per RBC unit. CONCLUSIONS We found significant costs associated with RBC transfusion for TDT, with the product cost contributing less than one‐half of the total cost.