Unpacking the true cost of red cell transfusion in MDS
Red cell transfusions are frequently required in patients with myelodysplastic syndromes (MDS), yet the overall cost of transfusion, extending beyond the unit price, is not well defined.
Investigators undertook an observational prospective study at Monash Medical Centre, a 640-bed tertiary-level university hospital in Melbourne, Australia. Utilising a time-driven activity-based costing model in a real-world setting, they sought to determine the true total cost of providing red cell support to patients with MDS by measuring every step of the transfusion pathway.
The red cell transfusion episode was divided into 4 phases:1) Pretransfusion phlebotomy, 2) Laboratory processes, 3) Clinical transfusion processes and 4) Additional processes relating to transfusion.
The study was undertaken to capture the activities and costs borne by the healthcare provider. Out-of-pocket costs to patients (such as transport) or societal costs (such as productivity loss) while highly important, were out of scope. Data analysis commenced in 2023, with costs based on 2023 values.
The total estimated cost per red cell unit transfused was calculated to be US$440.47 with a yearly cost of US$6,607 per patient (median of 7.5 units transfused). Product procurement price was the primary contributor to the overall cost (almost 60%). Of hospital-related costs, the main contributor was equipment (around 16%) followed by staffing (around 14%) and consumables (around 11%).
Alloimmunisation, common in patients with MDS, increased the estimated process costs for a simple antibody by 24%. Higher costs are likely for those with complex or multiple antibodies.
These findings can inform future cost evaluations of therapies for MDS-related anaemia while also supporting hospitals and governments in forecasting costs of supplying transfusion.
Reference:
- Mo A, Haysom H, Carrandi A, de Albornoz SC, Guglielmino J, Rushford K, et al. The true cost of red cell transfusion for patients with myelodysplastic syndromes: A time-driven activity-based costing study. Br J Haematol. 2026; 00:111.
https://doi.org/10.1111/bjh.70556