title: Plasma for fractionation in a public setting: cost analysis from the perspective of the third-party payer.
abstract: BACKGROUND
  In Italy, within the legal mandate to pursue national self-sufficiency of plasma-derived medical products, the Regions are starting to organise trade to offset imbalances between need and availability. It is, therefore, necessary to determine the full cost to the Regions of plasma collection and handling. Here we report an analysis of plasma production costs in the Department of Transfusion Medicine of Verona Province, Veneto Region.
  
  
  METHODS
  Plasma is obtained from voluntary, non-remunerated donors from either whole blood or apheresis donation, and in Verona it is collected, validated and distributed only in Regional Health Service facilities, and then delivered to industry for processing. The amounts and costs of materials and activities needed to collect, produce, validate and distribute plasma were obtained from the Department of Transfusion Medicine. Attributable overhead expenses were assumed at 15% of direct costs. When plasma was collected as part of whole blood or from multi-component apheresis, joint costs (the costs of the common manufacturing process before the separation) were allocated to the plasma based on the tariff for single components, taken as proxy of the willingness to pay for them. In an alternative scenario plasma recovered from whole blood donations was considered a by-product.
  
  
  RESULTS
  The estimated full cost of each valid unit of plasma derived from whole blood, multi-component apheresis, and plasma-apheresis was about € 30, € 73 and € 170, respectively. The estimated total cost per litre of plasma was € 113 for collection from whole blood and € 276 for collection from apheresis. When plasma recovered from whole blood donations was considered a by-product, its cost per litre was estimated to be € 26.
  
  
  CONCLUSIONS
  Our results suggest that the Italian donor-based system, in addition to its ethical and social values, can supply plasma at an affordable cost, comparable (albeit slightly higher) with costs in other recent analyses.
authors: Department of Pharmacological Sciences and Technology, University of Turin, Verona, Italy.
authors: Mario
authors: M
authors: Eandi
authors: Department of Transfusion Medicine, Integrated University Hospital, Verona, Italy.
authors: Giorgio
authors: G
authors: Gandini
authors: AdRes, Health Economics&Outcome Research, Turin, Italy.
authors: Massimiliano
authors: M
authors: Povero
authors: AdRes, Health Economics&Outcome Research, Turin, Italy.
authors: Orietta
authors: O
authors: Zaniolo
authors: AdRes, Health Economics&Outcome Research, Turin, Italy.
authors: Lorenzo
authors: L
authors: Pradelli
authors: Department of Transfusion Medicine, Integrated University Hospital, Verona, Italy.
authors: Giuseppe
authors: G
authors: Aprili
mesh_terms: D001781:Blood Component Removal / Q000191:economics*; D001782:Blood Donors; D003365:Costs and Cost Analysis; D006801:Humans; D007558:Italy; D010949:Plasma
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