Cost of chronic red blood cell transfusion in the Brazilian private healthcare sector from a payer perspective

Abstract

Objective: In the private healthcare sector in Brazil, the dearth of information regarding transfusion cost may compromise the management of conditions requiring long-term transfusion. Therefore, the present study aimed to estimate the cost of chronic red blood cell (RBC) transfusion in this context. Methods: A payer perspective was chosen for the analysis. A survey performed by an expert advisory board gathered information on the amounts reimbursed by health plans to blood centers per outpatient transfusion of a single RBC bag in multitransfused patients. Survey results were contrasted to RBC transfusion cost calculated using Brazilian Hierarchical Classification of Medical Procedures (CBHPM) parameters from 2018 and 2010, the latter suggested by the advisory board as more accurately reflecting market prices. Results: Six blood centers in the South and Southeast of Brazil were surveyed. The median amount reimbursed per RBC unit was R$ 1,066.44 (interquartile range: R$ 665.00-1,252.00). The mean amount reimbursed was R$ 959.54 ± R$ 337.14 (minimum: R$ 295.00 – maximum: R$ 1,980.00). Using 2018 CBHPM parameters, the cost of transfusing one RBC unit was calculated as R$ 1,905.18. Using 2010 CBHPM parameters, the cost was R$ 1,119.69 per RBC unit. Conclusions: Analyses using 2018 CBHPM parameters may lead to overestimation of transfusion cost. The best estimate for outpatient transfusion of one RBC bag in the private health care sector in Brazil lies between the observed reimbursed values and 2010 CBHPM cost. The present results provide valuable information for future cost-effectiveness analyses focusing on disorders whose treatment involves routine RBC transfusion.

Índice de Mentzer como adjuvante no diagnóstico diferencial da talassemia beta heterozigota e anemia ferropriva

“…Uma sessão de terapia transfusional pode variar de R$ 1.119,69 a R$ 1.905,18, levando a um custo mensal, por paciente, entre quatro e oito mil reais para o Sistema Único de Saúde (SUS). 13 O Rio Grande do Sul recebeu seu primeiro contingente populacional de imigrantes entre o fim do século XVIII e o início do século XIX, e se tornou mais intenso no período entre 1870 e 1914 quando através de um programa colonizador do governo brasileiro entraram no estado do Rio Grande do Sul de oitenta a cem mil imigrantes italianos. 14 splenomegaly, anemia with significant hemoglobin deficiency, bone marrow hyperplasia and, in some cases, imminent need for blood transfusion.…”

“…Por ser uma doença de origem genética, a prole de dois indivíduos heterozigotos tem 25% de chance de ser homozigota, ou seja, portadora de ß-talassemia maior. 13 O diagnóstico confirmatório das talassemias é, majoritariamente, realizado por dois métodos: a eletroforese quali/quantitativa de hemoglobinas variantes ou a Cromatografia Líquida de Alta Eficiência (HPLC/CLAE). A presença de uma porcentagem maior que 3,5% / 4% de HbA2 é confirmatória de paciente talassêmico.…”