Cost Reduction in Blood Transfusions After Implementation of Decision Protocol Based on Hemoglobin and Anemia Symptoms: A Pre-Post Analysis.

BACKGROUND Blood products are an expensive resource. The study aimed to assess the cost spent on red blood cell (RBC) transfusions before and after implementing a 2-factorial RBC transfusion decision protocol and the current cost of an RBC transfusion procedure in the local healthcare system. MATERIAL AND METHODS Six-month periods before and after the implementation of the decision protocol were compared. The cost components considered included RBCs, laboratory tests, labor of healthcare workers involved in the procedure, and management of transfusion reactions. RESULTS Following the implementation of the decision protocol, there was a decrease in transfusion costs by €51,411 (56.4%) in our low transfusion rate setting. Inappropriate RBC transfusions amounted to €25,0146 (62.9% of all transfusions costs). The cost of a leucodepleted RBC transfusion increased in the periods being compared, from approximately €109 to €126 in the local healthcare system. CONCLUSIONS Implementing an RBC transfusion decision protocol based on a 2-factorial approach can lead to a more than 2-fold reduction in cost spent on RBC transfusions in a low transfusion rate setting. Even after the implementation of the protocol, further education of clinicians is required, as there may still be potential to reduce costs associated with inappropriate transfusions. The non-RBC acquisition cost of an RBC transfusion procedure approximates the cost of a blood component itself in the local healthcare system.