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Dates: 2011-2017
Funding: Part funded by NHS Blood and Transplant
Collaborators: Dr Simon Stanworth, NHS Blood and Transplant
Project Team: Elizabeth Stokes, Sarah Wordsworth
Further Information Elizabeth Stokes

A blood transfusion is one of the most common procedures in hospitals, and yet the true cost of administering a transfusion is not known. Without reliable estimates of the costs of administering blood, these costs are frequently excluded from economic evaluations of blood transfusion strategies or healthcare interventions where patients may be given blood. This is potentially problematic: cost results will be biased in favour of the intervention with the greater blood use (by making that strategy appear less costly than it really is). Our study therefore aimed to generate comprehensive estimates of the costs of administering transfusions of different blood products for the UK NHS, through detailed measurement and valuation of resource inputs.

We undertook a detailed micro-costing study to cost two key inputs into transfusion: transfusion laboratory inputs for grouping and issuing blood, and nursing inputs associated with blood samples for group and screens and administering blood.  For each input, data collection forms were developed to capture staff time, equipment and consumables associated with each step in the transfusion process.  A total of 438 data collection forms were completed by 74 staff. Costing results were combined with costs of blood product wastage to calculate the cost per unit transfused, separately for different blood products.

Findings: The cost of administering blood was £49 per unit for red blood cells (RBCs), £58 for platelets, £38 for fresh frozen plasma (FFP) and £49 for cryoprecipitate in 2014/15 prices.  The costs of blood administration add substantially to the costs of the blood products themselves. For RBCs, costs are 40% higher when the costs of administration are added to the cost of RBCs; the cost of administering FFP exceeds the cost of the blood product itself. These are also frequently incurred costs; applying estimates to the blood components supplied to UK hospitals in 2015, the annual cost of blood administration, excluding blood products, exceeds £120 million. These cost estimates can be used in economic evaluations of blood transfusion strategies or healthcare alternatives which include transfusion to avoid introducing bias into results.


Accurate costs of blood transfusion: a micro-costing of administering blood products in the United Kingdom National Health Service.

Stokes EA, Wordsworth S, et al (2018) Transfusion