Cost of red blood cell transfusion; evaluation in a French academic hospital

The economic impact of Patient blood management (PBM) must be assessed beyond the acquisition cost of blood products alone. The estimate of indirect costs may vary depending on the organization and the elements taken into account. The transposition of data from the literature into a specific local context is therefore delicate. The objective of this work was to evaluate the overall cost of red blood cell concentrate (RBC) transfusion from a French healthcare establishment point of view. We carried out an activity based costing analysis in our hospital for the year 2018. The steps of the transfusion process and additional costs were detailed and cumulated (resource consumption, labor time, frequency) to populate the ABC model. Several scenarios were developed focusing either on RBC, all blood products or the surgical activity, and a univariate sensitivity analysis was conducted. The average total cost of transfusion, including acquisition cost, was 339,64 euros per RBC transfused. The cost of administration was 138.41 euros/RBC. Focusing only on surgical activities increased this cost (152.43 euros) while taking all blood products into account reduced it (92.49 euros). The difference in our results with the literature confirms the local variability in the cost of transfusion, which may affect the economic impact of PBM. Our study related to the specific context of a single French institution has limitations that a multicenter study would clarify in order to carry out economic modelling of transfusion optimization and alternatives and to guide the choice of PBM strategies at the national level. L’impact économique du patient blood management (PBM) doit être évalué au-delà du seul coût d’acquisition des produits sanguins. L’estimation des coûts indirects peut varier selon les organisations et les éléments pris en compte. La transposition des données de la littérature dans un contexte local spécifique s’avère ainsi délicate. L’objectif de ce travail était d’évaluer le coût de la transfusion de Concentrés de globules rouges (CGR) du point de vue d’un établissement de soins français. Nous avons réalisé une analyse de coût basée sur l’activité de notre hôpital pour l’année 2018. Plusieurs scénarios ont été élaborés portant sur les CGR seuls, l’ensemble des produits sanguins ou centré sur l’activité chirurgicale et une analyse de sensibilité univariée a été menée. Le coût total moyen de la transfusion de CGR, était de 339 64 euros par unité transfusée en incluant