The cost of blood in paediatric oncology patients

Abstract

Introduction: Consumption of blood products is significant aiming to treat low cell counts and improve quality of life however 9% to 44% of the total consumption in centres abroad are unjustified. We reviewed thresholds at which blood products were administered and costs incurred by administering blood products at the local paediatric oncology ward at Mater Dei hospital and assessed whether they were inkeeping with local guidelines. Methods: Patient files were analyzed retrospectively for demographics, disease, type and amount of blood products used from January to May 2013. The costs involved were obtained from the Blood Bank at Mater Dei Hospital. The standards used were the protocol by HBB regarding administration on KURA and ‘Supportive care protocols’ in paediatric oncology and haematology. Results: Nine children were given blood products. Red cell products (RCP) use ranged from 0-10 units. and platelets derived products ranged 0- 12 units per patient. haemoglobin levels and platelet counts before transfusions ranged from 3.1 to 8.6g/dL and 9 to 60x109/L respectively. The total cost for the department was €17,950 while the total amount spent for tests done prior to ordering products was €3,276 out of 22 RCP requests for transfusion only once were RCPs transfused above the standard 7g/dL. Platelets were requested 26 times. Documentation regarding the reason for administration was lacking in patient files. Conclusion: The use of blood products is dependent on patient needs and is not influenced by prices. Thresholds at which platelets and RCP are administered vary according to the clinical scenario. Rising costs and shrinking donor pools require blood products to be used judiciously.