The societal unit cost of allogenic red blood cells and red blood cell transfusion in Canada

BACKGROUND: There is a dearth of information about the cost of allogenic red blood cells (RBCs) and RBC transfusion in Canada in the aftermath of the Canadian blood system reorganization and the introduction of various safety measures. The unit cost of allogenic RBCs and RBC transfusion in Canada in 1994 was estimated at US$152.17. The objective of this study was to determine the unit cost of allogenic RBC transfusion in Canada from a societal perspective. STUDY DESIGN AND METHODS: A cost-structure analysis using the cost information from 2001 through 2002 was used. Costs of blood collection, production, distribution, delivery (hospital transfusion service processing and patient administration), transfusion reaction management, and opportunity cost of donor's time were included in the analysis. Canadian Blood Services and Hema-Quebec supplied the data for collection, production, and distribution stages. Delivery and transfusion reaction costs were collected from eight hospitals across six Canadian provinces. In-patient costs were assessed for the intensive care unit, emergency, general medicine ward, and operating room. RESULTS: The aggregate mean societal unit cost of RBCs transfused on an inpatient basis in 2002 was US$264.81 (95% confidence interval [CI], $256.29-$275.65). The mean cost of blood collection, production, and distribution was US$202.74 (95% CI, $199.63-$204.31), the mean opportunity cost of donor time was US$18.21 (95% CI, $17.11-$21.63), the mean cost of hospital transfusion service processing was US$16.65 (95% CI, $13.50-$19.79), of RBC transfusion was US$26.92 (95% CI, $25.33-$28.52), and of transfusion reaction management was US$0.29 (95% CI, $0.22-$0.36). There were substantial variations in hospital transfusion service processing and RBC transfusion costs across hospitals. CONCLUSION: The societal unit cost of RBC transfusion has doubled since 1994 to 1995. Further increases in unit costs would be expected as additional safety measures are introduced. This will have important financial implications for treating patient populations that require a high level of RBC transfusions.