title: Sustainability of a public system for plasma collection, contract fractionation and plasma-derived medicinal product manufacturing.
abstract: BACKGROUND
  In Italy, the financial reimbursement for labile blood components exchanged between Regions is regulated by national tariffs defined in 1991 and updated in 1993-2003. Over the last five years, the need for establishing standard costs of healthcare services has arisen critically. In this perspective, the present study is aimed at defining both the costs of production of blood components and the related prices, as well as the prices of plasma-derived medicinal products obtained by national plasma, to be used for interregional financial reimbursement.
  
  
  METHODS
  In order to analyse the costs of production of blood components, 12 out 318 blood establishments were selected in 8 Italian Regions. For each step of the production process, driving costs were identified and production costs were. To define the costs of plasma-derived medicinal products obtained by national plasma, industrial costs currently sustained by National Health Service for contract fractionation were taken into account.
  
  
  RESULTS
  The production costs of plasma-derived medicinal products obtained from national plasma showed a huge variability among blood establishments, which was much lower after standardization. The new suggested plasma tariffs were quite similar to those currently in force. Comparing the overall costs theoretically sustained by the National Health Service for plasma-derived medicinal products obtained from national plasma to current commercial costs, demonstrates that the national blood system could gain a 10% cost saving if it were able to produce plasma for fractionation within the standard costs defined in this study.
  
  
  CONCLUSIONS
  Achieving national self-sufficiency through the production of plasma-derived medicinal products from national plasma, is a strategic goal of the National Health Service which must comply not only with quality, safety and availability requirements but also with the increasingly pressing need for economic sustainability.
authors: National Blood Centre, National Institute of Health, Rome, Italy.
authors: Giuliano
authors: G
authors: Grazzini
authors: Università Cattolica del Sacro Cuore, Graduate School of Health Economics and Management, Rome, Italy.
authors: Anna
authors: A
authors: Ceccarelli
authors: National Blood Centre, National Institute of Health, Rome, Italy.
authors: Deanna
authors: D
authors: Calteri
authors: National Blood Centre, National Institute of Health, Rome, Italy.
authors: Liviana
authors: L
authors: Catalano
authors: National Blood Centre, National Institute of Health, Rome, Italy.
authors: Gabriele
authors: G
authors: Calizzani
authors: Università Cattolica del Sacro Cuore, Graduate School of Health Economics and Management, Rome, Italy.
authors: Americo
authors: A
authors: Cicchetti
mesh_terms: D003365:Costs and Cost Analysis; D004345:Drug Industry / Q000191:economics*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D004364:Pharmaceutical Preparations / Q000191:economics* / Q000600:supply & distribution*; D010949:Plasma; D010956:Plasmapheresis / Q000191:economics*; D012189:Retrospective Studies
chemical_list: D004364:Pharmaceutical Preparations