Economic consequences of alterations in platelet transfusion dose: analysis of a prospective, randomized, double-blind trial.
BACKGROUND
In recent years, decreasing financial resources led to the use of lower-dose platelet components. However, the economic consequences of the use of such components have not been carefully studied.


METHODS
A formal economic analysis was conducted of a recently reported, prospective, randomized, double-blind study examining the platelet dose-response relationship in nonrefractory patients. The economic analysis used a decision analysis model, conducted from the hospital's perspective and based directly on the observed clinical data and on institutional cost structures.


RESULTS
The decision analysis model estimated that a 38-percent reduction in mean platelet dose, within the commonly prescribed dose range, would result in the average patient's requiring approximately 60 percent more transfusions in the posttransplant period (8 vs. 5; p = 0.05), which would result in an estimated 60-percent increase in the median cost to the hospital ($4486/patient vs. $2804/patient [in 1996 US dollars], p = 0.05).


CONCLUSIONS
Efforts to decrease costs by utilizing lower-dose single-donor platelet transfusions are predicted to result in a disproportionate increase in the number of transfusions per patient, with a corresponding increase in overall hospital transfusion costs.
Ackerman
S J
SJ
Covance Health Economics and Outcomes Services, Inc., Gaithersburg, MD, USA.
Klumpp
T R
TR
Guzman
G I
GI
Herman
J H
JH
Gaughan
J P
JP
Bleecker
G C
GC
Mangan
K F
KF
D000328:Adult; D003365:Costs and Cost Analysis; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000191:economics*; D011446:Prospective Studies