How Should Canada Fund the Blood System? An Evaluation of the Chargeback Proposal

Wilson, Kumanan; MacDougall, Laura; Pinard, Brigitte; Amin, Mohammad Al; Fergusson, Dean; Graham, Ian; Blajchman, Morris A.; Freedman, John; Angus, Douglas E; Hébert, Paul C.

doi:10.12927/hcq..16635

Cited by 4 publications

(3 citation statements)

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“…This is contrasted to the lack of access to and the high costs of novel therapies directed at autoimmune diseases. In all Canadian provinces except Quebec, Canadian Blood Services provides blood products to hospitals free of charge . In health systems where there are currently no obvious fiscal incentives for hospitals to control the use of blood products, the existing payment framework for blood products may be an obstacle to the effective control of IVIG administration …”

Section: Discussionmentioning

confidence: 99%

Trends in IVIG use at a tertiary care Canadian center and impact of provincial use mitigation strategies: 10‐year retrospective study with interrupted time series analysis

et al. 2019

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BACKGROUND: Intravenous immunoglobulin (IVIG) is a fractionated plasma product used to treat a range of autoimmune or inflammatory conditions, as well as immunodeficiency. Demand for this high-cost product is increasing worldwide. Understanding historical changes in IVIG use is important for inventory management and demand forecasting as well as for the development of initiatives aimed at optimizing blood product use. ABBREVIATIONS: ITS = interrupted time series; IVIG = intravenous immunoglobulin; SCIG = subcutaneous immunoglobulin.From the

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Section: Discussionmentioning

confidence: 99%

Trends in IVIG use at a tertiary care Canadian center and impact of provincial use mitigation strategies: 10‐year retrospective study with interrupted time series analysis

et al. 2019

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“…In Canada, over a three-year period since the blood system underwent structural reform, expenditures in the blood system have increased by 50% . These rising blood system costs have been attributed to several factors including the increase in use of blood products, and the increase in cost of specific blood products such as intravenous immunoglobulin (Wilson, MacDougall et al, 2003). However, attention has particularly been focused on the introduction of new safety measures that have only marginally improved the safety of the blood supply.…”

Section: Risk Aversion and Increasing Costsmentioning

confidence: 99%

Variant Creutzfeldt–Jakob disease and the Canadian blood system after the tainted blood tragedy

Wilson

Graham

Ricketts

et al. 2007

Social Science & Medicine

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The transfusion transmission of hepatitis C and HIV to thousands of Canadian blood recipients was one of this country's largest public health catastrophes. In response to this crisis, and in an effort to prevent such a tragedy from occurring again, the Canadian blood system has undergone substantial reform. Variant Creutzfeldt-Jakob (vCJD) disease was the first infectious threat faced by the blood system since undergoing reform. The response at the time to this risk provides insights into the Canadian blood system's new approach to infectious threats. Our analysis of the decision-making concerning vCJD identifies two dominant themes characterizing the new blood system's approach to safety: (1) the adoption of a precautionary approach to new risks which involves taking action in advance of definitive evidence, and (2) risk aversion amongst policy makers, which has contributed to the adoption of safety measures with comparatively high cost-effectiveness ratios. Overall the principles governing the new blood system have contributed to the system both providing protection against emerging infectious risks and regaining the confidence of the public and recipients. However, the current set of policy factors will likely contribute to increasingly risk-averse policy making that will contribute to continued increases in the cost of the blood system. The challenge the blood system now faces is to find the appropriate balance between maximizing safety and ensuring the system remains affordable.

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“…Provincial governments provide funding and both CBS and H-Q are federally regulated. CBS is responsible for the acquisition of all plasma derivatives and recombinant proteins and their distribution, either through custom fractionation contracts or commercial purchasing contracts (Rock et al, 2000;Wilson et al, 2003). Although self-sufficient in fresh blood, Canada is not self-sufficient in plasma for fractionation importing 50% of its supply, which is sourced from paid volunteer donors, mostly from the United States (Rock et al, 2000).…”

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confidence: 99%

Community attitudes to remunerated blood donation in Australia: results from a national telephone survey

Bambrick

Gallego

2013

Transfusion Medicine

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How Should Canada Fund the Blood System? An Evaluation of the Chargeback Proposal

Cited by 4 publications

References 0 publications

Trends in IVIG use at a tertiary care Canadian center and impact of provincial use mitigation strategies: 10‐year retrospective study with interrupted time series analysis

Trends in IVIG use at a tertiary care Canadian center and impact of provincial use mitigation strategies: 10‐year retrospective study with interrupted time series analysis

Variant Creutzfeldt–Jakob disease and the Canadian blood system after the tainted blood tragedy

Community attitudes to remunerated blood donation in Australia: results from a national telephone survey

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