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. 2013 Sep;11 Suppl 4(Suppl 4):s138-47.
doi: 10.2450/2013.020s.

Sustainability of a Public System for Plasma Collection, Contract Fractionation and Plasma-Derived Medicinal Product Manufacturing

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Free PMC article

Sustainability of a Public System for Plasma Collection, Contract Fractionation and Plasma-Derived Medicinal Product Manufacturing

Giuliano Grazzini et al. Blood Transfus. .
Free PMC article

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.

Materials and 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.

Discussion: 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.

Figures

Figure 1
Figure 1
Cost of production of a unit of whole blood (450 mL ± 10%) in 12 Blood Establishments (A–N) (year 2009).
Figure 2
Figure 2
Cost of production of a unit of recovered plasma frozen within 6 hours of collection (average weight 260 g) in 12 Blood Establishments (A–N) (year 2009).
Figure 3
Figure 3
Cost of production of a unit of recovered plasma frozen between 6 and 72 hours of collection (average weight 260 g) in 8 Blood Establishments (A–N) (year 2009).
Figure 4
Figure 4
Cost of production of a unit of plasmapheresis plasma (average weight 559 g) in 12 Blood Establishments (A–N) (year 2009).
Figure 5
Figure 5
Standardised cost of production of a unit of whole blood (450 mL ± 10%) in 12 Blood Establishments (A–N) (year 2009).
Figure 6
Figure 6
Standardised cost of production of a unit of recovered plasma frozen within 6 hours of collection (average weight 260 g) in 12 Blood Establishments (A–N) (year 2009).
Figure 7
Figure 7
Standardised cost of production of a unit of recovered plasma frozen between 6 and 72 hours of collection (average weight 260 g) in 8 Blood Establishments (A–N) (year 2009)
Figure 8
Figure 8
Standardised cost of production of a unit of plasmapheresis plasma (average weight 559 g) in 12 Blood Establishments (A–N) (year 2009).
Figure 9
Figure 9
Spread and efficiency of apheresis in Italy (year 2009). Source: SIdEM-SIMTI apheresis register, 2009.

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