Challenging transfusion policy

In a recent editorial, UK blood-transfusion experts argue that the spiraling cost of maintaining and improving the safety of the blood supply is becoming increasingly less cost effective.  Over the past ten years the cost of the UK blood supply doubled in real terms from GBP 250 to GBP 500 million. 

Most of this increase is due to the introduction of new tests or processes aimed at reducing the transmission of infective disease to recipient patients. Much of this money, the authors concede, has been well spent, but in some instances minimal increase in safety has proved hugely, perhaps unjustifiably, costly. 

Reducing blood transmission of new variant Creutzfeldt-Jacob disease (vCJD), for example, currently costs GBP 70 million each year and consideration is now being given to more effective procedures that would add a further GBP 100 million to the blood products bill. 

It remains unclear how many lives would be saved by this injection of cash, but since only two cases of vCJD caused by blood transfusion have ever been identified, the cost per life saved would be "enormous". Meanwhile, limited research suggests that many patients are exposed to the dangers of blood transfusion without gaining any real benefit. 

The authors of this editorial argue that money would be better spent on research aimed at identifying more precisely those patients who really gain benefit from transfused blood products. The improved, evidence-based approach to the use of blood products that would flow from this research, would likely reduce the number of patients exposed to blood products and associated risks. 

This, the experts argue, may now be a more cost-effective strategy for reducing transfusion-related morbidity and mortality.