Determinants of costs in blood services: blood transfusion from an economic perspective

Over the past decade, technology-driven inflation of blood transfusion costs has largely exceeded the medical component of the consumer price index. This tendency may speed up in the near future, despite poor cost-effectiveness projections and the low capacity of new technologies to produce clinically appreciable quality improvements or an increased productivity. Although labor is the costlier input, there has been little research and development aimed at substituting capital for labor in blood services. Substantial advances in efficiency can come only from a whole process re-engineering and adoption of a societal perspective in decision-making. There are, however, many barriers to such changes. Notably, the monopolistic nature of blood services, the perverse incentives derived from their current structure, with an increasing gap between the interests of producers and users, pressures by industry, cultural perceptions about blood and the political and judicial consequences of the transfusion AIDS epidemic.