The average unit production cost of blood in Zimbabwe from a provider's perspective

Background/Case Studies: Blood utilization and blood transfusion costs are generally perceived to be increasing at a time when healthcare budgets continue being constricted. There is a paucity of published data on the production costs of blood and the costs of blood transfusion in sub-Saharan Africa. Blood transfusion costs from developed countries are likely not transferable to the sub-Sahara African region, due to differences in models for collecting blood, the level of processing into components, and implementation of sophisticated blood safety measures. This study aimed to assess the unit costs of production of blood at the national blood service by using standardized methodology. Study Design/Methods: A management accounting approach, based on the Activity- Based Costing (ABC) methodology, was chosen to develop the cost model from the provider's perspective. The production of blood was broken down into recruitment, collection, processing and storage, and distribution. Data covering the calendar year of 2013 were collected retrospectively from the budgets, financial and expenditure reports, databases, and interviews with transfusion personnel and managers. All direct and indirect costs (capital and recurrent), in 2013 US$, were allocated accordingly to the components of blood acquisition. Results/Findings: Of the 70,834 donation visits (including repeat visits) that were screened in 2013, 67,440 visits (95.2%) were accepted for donation and, of these, the number of useful units of whole blood collected was 67,422 (99.9%). The total number of units of safe blood prepared was 70,636, and the total number of units distributed was 62,624 (88.7%). The total cost of producing blood for the year 2013 stood at US$8.3 million. Recurrent costs accounted for 94.2% of the total cost of production. The major cost drivers for the recurrent costs were personnel (38.5%) and laboratory supplies (31.9%). The unit production costs for recruitment, collection, processing, storage, and distribution were US$22.44, US$30.90, USD$73.00, and USD$5.75, respectively. The overall unit production cost for 2013 was US$132.10, 18.5% of the country's GDP per capita. Conclusion: These findings show that acquiring safe blood in an underdeveloped country is an expensive undertaking compared to that in the United States (0.4% of GDP). To account for all of the blood transfusion costs, this study has to be expanded to include all of the vein-to-vein incurred costs of transfusion