Eandi Mario, Gandini Giorgio, Povero Massimiliano, Zaniolo Orietta, Pradelli Lorenzo, Aprili Giuseppe
Department of Pharmacological Sciences and Technology, University of Turin, Verona, Italy.
Department of Transfusion Medicine, Integrated University Hospital, Verona, Italy.
Blood Transfus. 2015 Jan;13(1):37-45. doi: 10.2450/2014.0066-14.
In Italy, within the legal mandate to pursue national self-sufficiency of plasma-derived medical products, the Regions are starting to organise trade to offset imbalances between need and availability. It is, therefore, necessary to determine the full cost to the Regions of plasma collection and handling. Here we report an analysis of plasma production costs in the Department of Transfusion Medicine of Verona Province, Veneto Region.
Plasma is obtained from voluntary, non-remunerated donors from either whole blood or apheresis donation, and in Verona it is collected, validated and distributed only in Regional Health Service facilities, and then delivered to industry for processing. The amounts and costs of materials and activities needed to collect, produce, validate and distribute plasma were obtained from the Department of Transfusion Medicine. Attributable overhead expenses were assumed at 15% of direct costs. When plasma was collected as part of whole blood or from multi-component apheresis, joint costs (the costs of the common manufacturing process before the separation) were allocated to the plasma based on the tariff for single components, taken as proxy of the willingness to pay for them. In an alternative scenario plasma recovered from whole blood donations was considered a by-product.
The estimated full cost of each valid unit of plasma derived from whole blood, multi-component apheresis, and plasma-apheresis was about € 30, € 73 and € 170, respectively. The estimated total cost per litre of plasma was € 113 for collection from whole blood and € 276 for collection from apheresis. When plasma recovered from whole blood donations was considered a by-product, its cost per litre was estimated to be € 26.
Our results suggest that the Italian donor-based system, in addition to its ethical and social values, can supply plasma at an affordable cost, comparable (albeit slightly higher) with costs in other recent analyses.
在意大利，为实现血浆衍生医疗产品的国家自给自足这一法定任务，各地区开始组织贸易以抵消需求与供应之间的不平衡。因此，有必要确定各地区血浆采集和处理的全部成本。在此，我们报告对威尼托大区维罗纳省输血医学部血浆生产成本的分析。
血浆来自自愿无偿献血者的全血或单采，在维罗纳，血浆仅在地区卫生服务机构进行采集、验证和分发，然后交付给企业进行加工。从输血医学部获取采集、生产、验证和分发血浆所需材料及活动的数量和成本。可归属间接费用假定为直接成本的15%。当血浆作为全血的一部分采集或从多成分单采中获取时，联合成本（分离前共同制造过程的成本）根据单成分的费率分配到血浆上，该费率被视为对它们支付意愿的替代指标。在另一种情况下，从全血捐献中回收的血浆被视为副产品。
从全血、多成分单采和单采血浆中获得的每单位有效血浆的估计总成本分别约为30欧元、73欧元和170欧元。从全血中采集每升血浆的估计总成本为113欧元，从单采中采集为276欧元。当从全血捐献中回收的血浆被视为副产品时，其每升成本估计为26欧元。
我们的结果表明，意大利基于献血者的系统，除了其伦理和社会价值外，还能以可承受的成本供应血浆，与其他近期分析中的成本相当（尽管略高）。
