A time‐driven, activity‐based costing methodology for determining the costs of red blood cell transfusion in patients with beta thalassaemia major

Background: This study aims to analyze the cost of the entire transfusion process in Turkey including evaluation of the cost of transfusion from the perspective of hospital management and determination of savings achieved with the transfusion improvement program. Methods: Invoices, labor, material costs were calculated with micro-costing method, while general production expenses were calculated with gross costing method between January 2018 and December 2019. Unit costs for each blood product were calculated separately by collecting unit acquisition costs, material costs, labor costs, and general production expenses and, then, distributed into six different blood products as follows: erythrocyte suspension, fresh frozen plasma, pooled platelet, apheresis platelet, cryoprecipitate, fresh whole blood. The total costs for 2018 and 2019 were calculated and the savings achieved were estimated. The Turkish Lira was converted into the United States Dollar ($) currency using the purchasing power parity. Results: In 2018/2019, the blood component transfusion cost was $240.90/251.18 for erythrocyte suspension, $120.00/128.67 for fresh frozen plasma, $313.50/322.19 for pooled platelet, $314.24/325.73 for apheresis platelet, $104.95/113.99 for cryoprecipitate, and $189.91/209.09 for fresh whole blood. The total transfusion cost was $6,224,208.33 in 2108 and $5,308,148.43 in 2019. As a result of the transfusion improvement program launched in 2019, the amount of blood components decreased by 23.24%, compared to the previous year, and a saving of $916,059.9 was achieved. Conclusion: The transfusion is a burden for both the hospital management systems and the country's economy. To accurately calculate and manage this economic burden is important for sustainable healthcare services.

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“…In most of the studies, procurement cost, labor cost, and material cost are common cost elements. [ 13 , 14 ]…”

Section: Discussionmentioning

confidence: 99%

The cost of one unit blood transfusion components and cost-effectiveness analysis results of transfusion improvement program

Indelen¹,

Kızmaz²,

Kar³

et al. 2021

Turk Gogus Kalp Dama

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“…In this scenario, the present approach combining CBHPM parameters and a reimbursement survey may be a useful strategy to estimate and update transfusion cost in the Brazilian private health care sector. Knowledge regarding transfusion cost is meaningful in a variety of contexts, from disorders requiring chronic transfusion, such as thalassemia (Burns et al, 2019) and MDS (Kuhne et al, 2010), to acute blood loss (Garcia-Roa et al, 2017). In the United Kingdom, a study focusing on lower vs. liberal levels of RBC administration to treat perioperative anemia associated with cardiac surgery (Stokes et al, 2016) has argued that the cost difference between the groups was "largely associated with the higher cost of red blood cells in the liberal group."…”

Section: Discussionmentioning

confidence: 99%

Cost of chronic red blood cell transfusion in the Brazilian private healthcare sector from a payer perspective

Magro¹,

Ribeiro²,

Sekine

et al. 2020

JBES

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Objective: In the private healthcare sector in Brazil, the dearth of information regarding transfusion cost may compromise the management of conditions requiring long-term transfusion. Therefore, the present study aimed to estimate the cost of chronic red blood cell (RBC) transfusion in this context. Methods: A payer perspective was chosen for the analysis. A survey performed by an expert advisory board gathered information on the amounts reimbursed by health plans to blood centers per outpatient transfusion of a single RBC bag in multitransfused patients. Survey results were contrasted to RBC transfusion cost calculated using Brazilian Hierarchical Classification of Medical Procedures (CBHPM) parameters from 2018 and 2010, the latter suggested by the advisory board as more accurately reflecting market prices. Results: Six blood centers in the South and Southeast of Brazil were surveyed. The median amount reimbursed per RBC unit was R$ 1,066.44 (interquartile range: R$ 665.00-1,252.00). The mean amount reimbursed was R$ 959.54 ± R$ 337.14 (minimum: R$ 295.00 – maximum: R$ 1,980.00). Using 2018 CBHPM parameters, the cost of transfusing one RBC unit was calculated as R$ 1,905.18. Using 2010 CBHPM parameters, the cost was R$ 1,119.69 per RBC unit. Conclusions: Analyses using 2018 CBHPM parameters may lead to overestimation of transfusion cost. The best estimate for outpatient transfusion of one RBC bag in the private health care sector in Brazil lies between the observed reimbursed values and 2010 CBHPM cost. The present results provide valuable information for future cost-effectiveness analyses focusing on disorders whose treatment involves routine RBC transfusion.

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“…The master process map is shown in Fig. , and the individual process maps have been published previously …”

Section: Methodsmentioning

confidence: 99%

“…Master flowchart of each process mapped during the study. Individual flow charts have been published separately . IAT = indirect antiglobulin test; MTU = Medical Therapy Unit.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2019

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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. P atients with transfusion-dependent thalassemia (TDT) require lifelong, regular red blood cell (RBC) transfusions to improve anemia and to suppress ineffective erythropoiesis and subsequent complications, such as splenomegaly, skeletal abnormalities, increased dietary iron absorption, and thrombosis. 1,2 Transfusing RBCs every 2 to 5 weeks has been shown to maintain the balance between inhibition of erythropoiesis and transfusion-related iron overload. 2 Allogeneic stem cell transplantation is the only current definitive cure for TDT; however, this procedure is limited by availability of matched donors and the risk of graft-versus-host disease. Encouragingly, many new therapeutic approaches with potential to transform management of β-thalassemia are currently being evaluated in clinical trials. ABBREVIATIONS: MMC = Monash Medical Centre; MTU = Medical Therapy Unit; TDABC = time-driven activity-based costing; TDT = transfusion-dependent thalassemia. From the

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A time‐driven, activity‐based costing methodology for determining the costs of red blood cell transfusion in patients with beta thalassaemia major

Abstract: Detailed process maps using bottom-up, time-driven, activity-based costing for determining the cost of RBC transfusion in thalassaemia major have been developed. These could be adapted for wider use to understand and compare the costs and complexities of transfusion in other settings.

Cited by 8 publications

References 12 publications

The cost of one unit blood transfusion components and cost-effectiveness analysis results of transfusion improvement program

The cost of one unit blood transfusion components and cost-effectiveness analysis results of transfusion improvement program

Cost of chronic red blood cell transfusion in the Brazilian private healthcare sector from a payer perspective

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

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