In a recent article about the seeming increase of blood use for treatment of End Stage Renal Disease (written and posted on The Bloody Truth blog), Dr. Carolyn Burns made the following comment:
"So, if indeed we are beginning to see an increase in transfusion in patients with ESRD, this may be a reflection of the regulatory and reimbursement changes as noted."
Let us never forget that in the West the bottom line is the bottom line. When reimbursement changes so does the use of drugs and services. We must realize and work within the system however as blood management professionals we must do what we can to resist dollar driven treatment decisions.
So the answer to the original question is sometimes as in 'Sometimes the decision to use or not use a transfusion alternative is based on reimbursement'. If the institution is forced to absorb the cost of anemia treatment and must chose between spending $4,500 or $1200 the pressure will be toward the lower figure. EPO and Iron, etc = $4,500, PRBC's = $1200. (Figures do not necessarily reflect current market)
Read the entire article here