Costing complexities in mixed apheresis

For mixed apheresis procedures {plasma (PMA) and platelets (PLTs) as products}, six cost-accounting methods are described for apportioning the unit procedure cost ($156.02; representative example) to the two products. The methods are derived from clinical/scientific apheresis principles, but provide a wide range of unit PLT costs ($14.10, 19.71, 34.37, 42.06, 43.82 and 52.00) which relate inversely to the corresponding unit PMA costs ($73.84, 63.01, 34.36, 19.37, 15.94 and 0.00). Two of the methods appear particularly appropriate, depending upon whether the procedure is driven by PLTs predominantly or by PMA+PLTs equally. The paper encourages apheresis physicians and scientists to debate the relative attributes of the methods, develop refinements of the same, and determine through dialogue that mixed apheresis costing models properly account for the clinical science of the service provided.