Using lean techniques to define the platelet (PLT) transfusion process and cost‐effectiveness to evaluate PLT dose transfusion strategies

Riley, William J.; Smalley, Benjamin; Pulkrabek, Shelley; Clay, Mary; McCullough, Jeffrey

doi:10.1111/j.1537-2995.2011.03539.x

Cited by 34 publications

(23 citation statements)

References 15 publications

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“…A cost analysis based on the dosing strategies used in the PLADO trial at 1 center estimated that the total apheresis platelet and transfusion administration costs for the average SCT patient would be US $4504 for low doses, US $5658 for medium doses, and US $7015 for high doses [43].…”

Section: Summary Of Evidence and Rationale For Recommendationmentioning

confidence: 99%

Guidance on Platelet Transfusion for Patients With Hypoproliferative Thrombocytopenia

Nahirniak

Slichter

Tanael

et al. 2015

Transfusion Medicine Reviews

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Section: Summary Of Evidence and Rationale For Recommendationmentioning

confidence: 99%

Guidance on Platelet Transfusion for Patients With Hypoproliferative Thrombocytopenia

Nahirniak

Slichter

Tanael

et al. 2015

Transfusion Medicine Reviews

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“…In the absence of PR, it was assumed that the hospital service received leukoreduced apheresis PLTs ($555.75), which then underwent irradiation and Zika testing . Nonproduct costs included expenses associated with the blood bank as well as transfusion itself and were based on a lean process analysis of PLT transfusion at a large academic medical center in the United States . Complication costs were drawn from a recent systematic review of hospital costs of sepsis in the United States and from published estimates of the cost of a visit to a hospital‐based emergency department for serious and mild complications from contamination, respectively.…”

Section: Methodsmentioning

confidence: 99%

Financial impact of alternative approaches to reduce bacterial contamination of platelet transfusions

et al. 2019

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BACKGROUND Bacterial contamination of platelets remains the leading infectious risk from blood transfusion. Pathogen reduction (PR), point‐of‐release testing (PORt), and secondary bacterial culture (SBC) have been proposed as alternative risk control strategies, but a comprehensive financial comparison has not been conducted. STUDY DESIGN AND METHODS A Markov‐based decision tree was constructed to model the financial and clinical impact of PR, PORt, and SBC, as well as a baseline strategy involving routine testing only. Hospitals were assumed to acquire leukoreduced apheresis platelets on Day 3 after collection, and, in the base case analysis, expiration would occur at the end of Day 5 (PR and SBC) or 7 (PORt). Monte Carlo simulations assessed the direct medical costs for platelet acquisition, testing, transfusion, and possible complications. Input parameters, including test sensitivity and specificity, were drawn from existing literature, and costs (2018 US dollars) were based on a hospital perspective. RESULTS The total costs per unit acquired by the hospital under the baseline strategy, PR, PORt, and SBC were $651.45, $827.82, $686.33, and $668.50, respectively. All risk‐reduction strategies decreased septic transfusion reactions and associated expenses, with the greatest reductions from PR. PR would add $191.09 in per‐unit acquisition costs, whereas PORt and SBC would increase per‐unit testing costs by $31.79 and $17.26, respectively. Financial outcomes were sensitive to platelet dating; allowing 7‐day storage with SBC would lead to a cost savings of $12.41 per transfused unit. Results remained robust in probabilistic sensitivity analyses. CONCLUSIONS All three strategies are viable approaches to reducing bacterially contaminated platelet transfusions, although SBC is likely to be the cheapest overall.

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“…Health care resources are limited and therefore it is important to understand what resources (and associated costs) are required to provide health care services. In the area of blood transfusion, while the total costs of actually administering the blood exceed the cost of the blood products themselves, there is limited international evidence on the magnitude of these administration costs . Furthermore, given the number of steps involved in the transfusion process, there are likely to be differences in practice between countries.…”

mentioning

confidence: 99%

Accurate costs of blood transfusion: a microcosting of administering blood products in the United Kingdom National Health Service

et al. 2018

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Blood administration costs add substantially to the costs of the blood products themselves. These are frequently incurred costs; applying estimates to the blood components supplied to UK hospitals in 2015, the annual cost of blood administration, excluding blood products, exceeds $175 (£120) million. These results provide more accurate estimates of the total costs of transfusion than those previously available.

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Using lean techniques to define the platelet (PLT) transfusion process and cost‐effectiveness to evaluate PLT dose transfusion strategies

Abstract: The overall cost of transfusion therapy is more influenced by the cost of the product than the cost of providing the transfusion. Depending on the cost adjustment by the supplier for different doses of PLTs, a low-dose transfusion strategy can be less costly.

Cited by 34 publications

References 15 publications

Guidance on Platelet Transfusion for Patients With Hypoproliferative Thrombocytopenia

Guidance on Platelet Transfusion for Patients With Hypoproliferative Thrombocytopenia

Financial impact of alternative approaches to reduce bacterial contamination of platelet transfusions

Accurate costs of blood transfusion: a microcosting of administering blood products in the United Kingdom National Health Service

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