Cost savings gained with PBM may benefit patients with rare diseases

Many countries have practiced patient blood management (PBM) and reaped benefits such as improvements in patients’ outcomes and reductions in blood transfusion rates. The cost savings obtained by reducing blood transfusion rates can be used to purchase medications for patients with lifelong rare disorders and improve their quality of life, says Dr Jameela Sathar, a consultant hematologist at Hospital Ampang.

PBM is a patient-centered, systematic, evidence-based approach to improve patient outcomes by managing and preserving the patient’s own blood, while promoting patient safety and empowerment. [Anesth Analg 2022;135(3):476-488] PBM works on the basis of optimizing hemostasis, minimizing blood loss and bleeding, and harnessing and optimizing tolerance of anemia. [Malaysian Society of Patient Blood Management. Available at https://www.pbmsia.com/pages/about. Accessed on 10 August 2023.]

Jameela pointed out that the real cost of blood transfusion incorporates the procurement of blood, transfusion microbiology, storage, supply management, pre-transfusion testing, and the administration and monitoring of blood transfusion. Hence, one bag of blood may cost US$700 to US$1000, and the cost escalates when adverse events are involved. [Transfusion 2010;50(4):753-765]

For example, if one bag of blood is estimated at RM1000 and an average of 2000 bags of blood are transfused in a day, RM2 million per day will be spent on blood transfusion alone. If practicing PBM can reduce the transfusion rates by just 10 percent, for example, RM200,000 can be saved in a day which adds up to RM6 million per month or RM72 million per year. All the cost savings can be channelled into budgets specific for each rare disorder and used to purchase drugs for the disorders such as hemophilia, paroxysmal nocturnal hemoglobinuria (PNH) and spinal muscular atrophy (SMA). Adequate and timely treatment can improve the patients’ quality of life, said Jameela.

Additional benefits of PBM include reduction of fatality, length of hospital stay, reoperation, readmissions, complications, and infection rates, said Jameela, in her opening remarks at the 1^st Annual Scientific Conference of the Malaysian Society of Patient Blood Management (MyPBM).