Results and Implications of a Red Blood Cell (RBC) and Platelet Transfusion Costing Exercise in Select Countries within Europe and North America

OBJECTIVES: As oncology treatments advance, their holistic value becomes ever more important, particularly cost burden and health system constraints. During broader decision-making, supportive therapy (ST), e.g. blood transfusions, are not always considered, which adds to patient/health system burdens due to accumulated costs and low availability of blood products. The objective of this analysis was to assess the cost of RBC and platelet transfusions among countries within Europe and North America and apply these findings to an example clinical trial.

METHODS: Transfusion costs in Europe (Austria, Denmark, France, Germany, Greece, Italy, the Netherlands, Poland, Portugal, Sweden, Switzerland, UK) and North America (Canada, the USA) were derived using diagnosis-related group values or micro-costing. Estimates were adjusted to local currency 2024 values using local price indices and converted to Euros. One- and two-unit RBC transfusion estimates were calculated and single-unit platelet transfusion estimates were derived. Costs were then applied to transfusion rates from the Phase 3 HD21 study in patients aged <60 years with newly diagnosed advanced Hodgkin lymphoma treated with BrECADD (brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, dexamethasone): RBC 24%, platelets 17% vs BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone): RBC 52%, platelets 34%. Estimates are by treatment arm and per patient (pp) during treatment and follow-up.

RESULTS: The included countries exhibited a range of transfusion-associated costs, estimated using diverse costing approaches. When German costs (other data to be presented) were applied to HD21, assuming receipt of two-unit RBC and one-unit platelet transfusions, cost savings were €1,943 (62%) and €299 (57%) pp, respectively, for BrECADD vs BEACOPP, considering only unit costs.

CONCLUSIONS: The cost of transfusions as ST can vary widely between countries. When treating oncology/hematology patients, this analysis suggests that the cost implications of transfusions associated with treatments may be an important healthcare decision-making consideration.