[The patient billing cost in medical biology: advantages and disadvantages]

Control of health expenditures in relation with staff reduction have led hospital or private labs to seek out growing productivity associated with limited costs. Consolidation and harmonization of equipment have to be implemented, as well as work positions, with the aid of computers. Analytical and preanalytical choices often converge towards the same manufacturer, and it is tempting to simplify also order, receipt and invoicing procedures. This cost optimization requires invoicing taking into account real activity of the lab, establishing "pay per patient" rather than "pay per kit". These changes may also apply to smaller analyzers such as those employed for haemostasis that are deployed in several sites, in aim to reduce costs. We describe the principles of this new mode of invoicing proposed by Roche Diagnostics, for which one may bring out main advantages and inconveniences.