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Medical and economic impact of a regional Patient Blood Management program in Navarre, Spain (2016-2025)
José Antonio García Erce1, Saioa Zalba Marcos2, Gabriel Cerdán3
1Banco de Sangre y Tejidos de Navarra, Pamplona, Navarra, España; Aragón Health Research Institute (IACS), Aragon Institute for Health Research (IIS Aragon), Zaragoza; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, España; Grupo de Investigación Gestión en el Paciente Sangrante-PBM, Instituto de Investigación Sanitaria, Hospital Universitaria La Paz (IdiPAZ), Madrid, España.
Introduction:
Patient Blood Management (PBM) is a comprehensive ethical strategy that improves clinical outcomes, reduces transfusion requirements, and optimizes the use of resources, with proven benefits in terms of efficiency, safety, and healthcare costs.
Methods:
We conducted a before-after observational study (2016-2025) from the perspective of the Blood Transfusion Center of the Chartered Community of Navarre. We analyzed trends in blood donation, the annual supply of red blood cell, plasma and platelet concentrates to hospitals, the volume of plasma sent for industrial fractionation, and the yield of plasma-derived medicinal products (albumin, immunoglobulins, factor VIII). Direct economic impact, under a neutral scenario, was estimated by applying the official 2025 tariffs to the number of units "not supplied" compared with 2016; indirect impact was calculated from the difference between contract fractionation costs and ex-factory prices for returned plasma-derived products.
Results:
With overall donations remaining stable, the supply of red blood cells and therapeutic plasma decreased steadily (by approximately 20-25% and >50%, respectively), with an accumulated reduction of close to 50,000 units supplied. The estimated direct savings exceeded 5.5 million euros over the study period. In parallel, plasma sent for fractionation increased by around 40%, with >40% increases in returned albumin and immunoglobulins, generating additional indirect savings of approximately 6.2 million euros through reduced dependence on commercial products.
Conclusions:
The progressive implementation of a regional PBM program, led by the blood transfusion center, is associated with a marked reduction in whole blood donation and in the consumption of blood components, together with an increase in apheresis donation and greater self-sufficiency in plasma-derived medicinal products, resulting in a very substantial direct and indirect economic impact for the healthcare system.
