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Economic consequences of alterations in platelet transfusion dose: analysis of a prospective, randomized, double-blind trial

Authors

  • Stacey J. Ackerman,

    1. From Covance Health Economics and Outcomes Services, Inc., Gaithersburg, MD; and the Temple University Bone Marrow Transplant Program and Department of Biostatistics, Temple University School of Medicine, Philadelphia, Pennsylvania.
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  • Thomas R. Klumpp,

    1. From Covance Health Economics and Outcomes Services, Inc., Gaithersburg, MD; and the Temple University Bone Marrow Transplant Program and Department of Biostatistics, Temple University School of Medicine, Philadelphia, Pennsylvania.
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  • Gladys I. Guzman,

    1. From Covance Health Economics and Outcomes Services, Inc., Gaithersburg, MD; and the Temple University Bone Marrow Transplant Program and Department of Biostatistics, Temple University School of Medicine, Philadelphia, Pennsylvania.
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  • Jay H. Herman,

    1. From Covance Health Economics and Outcomes Services, Inc., Gaithersburg, MD; and the Temple University Bone Marrow Transplant Program and Department of Biostatistics, Temple University School of Medicine, Philadelphia, Pennsylvania.
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  • John P. Gaughan,

    1. From Covance Health Economics and Outcomes Services, Inc., Gaithersburg, MD; and the Temple University Bone Marrow Transplant Program and Department of Biostatistics, Temple University School of Medicine, Philadelphia, Pennsylvania.
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  • Giselle C. Bleecker,

    1. From Covance Health Economics and Outcomes Services, Inc., Gaithersburg, MD; and the Temple University Bone Marrow Transplant Program and Department of Biostatistics, Temple University School of Medicine, Philadelphia, Pennsylvania.
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  • Kenneth F. Mangan

    1. From Covance Health Economics and Outcomes Services, Inc., Gaithersburg, MD; and the Temple University Bone Marrow Transplant Program and Department of Biostatistics, Temple University School of Medicine, Philadelphia, Pennsylvania.
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  • Supported in part by Baxter Healthcare Corporation.

Address reprint requests to: Thomas R. Klumpp, MD, Fox Chase–Temple University Bone Marrow Transplant Program, Friends Hall Physicians Building, 7604 Central Avenue, Philadelphia, PA 19111; e-mail: klumppt@tuhs.temple.edu.

Abstract

BACKGROUND : In recent years, decreasing financial resources led to the use of lower-dose platelet components. However, the economic consequences of the use of such components have not been carefully studied.

STUDY DESIGN AND METHODS: A formal economic analysis was conducted of a recently reported, prospective, randomized, double-blind study examining the platelet dose–response relationship in nonrefractory patients. The economic analysis used a decision analysis model, conducted from the hospital's perspective and based directly on the observed clinical data and on institutional cost structures.

RESULTS : The decision analysis model estimated that a 38-percent reduction in mean platelet dose, within the commonly prescribed dose range, would result in the average patient's requiring approximately 60 percent more transfusions in the posttransplant period (8 vs. 5; p = 0.05), which would result in an estimated 60-percent increase in the median cost to the hospital ($4486/patient vs. $2804/patient [in 1996 US dollars], p = 0.05).

CONCLUSION: Efforts to decrease costs by utilizing lower-dose single-donor platelet transfusions are predicted to result in a disproportionate increase in the number of transfusions per patient, with a corresponding increase in overall hospital transfusion costs.

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