Wednesday, July 28, 2010

Blood supply

The safety of and the degree to which the blood supply can help individuals in need of transfusions in the United States is an issue that we hear about often.  We see the flyers for blood drives.  We often hear that there are chronic shortages of blood.  A piece in the Baltimore Sun points out that despite the concerns about shortages, not all blood in storage in hospitals just arrived.  In fact, it can be up to six weeks old.  Now there is concern that older blood may introduce risks for individuals who receive tranfusions.

Where is the economics here?  First, what does a shortage mean when at least some blood is around for six weeks and hospitals have protocols to use the oldest blood in storage so that none goes to waste?  A shortage may be for specific blood types (presumably less common ones) while others are in relatively strong supply.  The economic definition of shortage--a price at which the demand is greater than the supply--is difficult to interpret as so few consumers who need blood transfusions have any idea of the costs.

The economics is about how to use scarce resources.  What are the risks?  What are we willing to give up to reduce the risks?  And who will make those decisions?

If current studies establish that the risks of older blood for certain transfusions are real, would we be willing to risk wasting donated blood to assure safer transfusions?  If donors knew this, would they change their behavior?  Should price be involved in accessing safer blood?  How would we as a society or even medical professional agree on what the risk/benefit tradeoff should be?

From a cost-effectiveness point of view, if we look at the ways in which newer blood could change mortality or quality of life and compare that with the resources that might be wasted by discarding older blood donations, would we find this to be cost-effective?  It is almost certain that changes relative to the status quo in the United States would be more expensive even if they are more effective.  The persective (societal? patient? hospital? blood collection organization?) would also be crucial. 

3 comments:

  1. Just to stir the pot, Richard Titmuss (http://en.wikipedia.org/wiki/Richard_Titmuss)found that the "gift relationship" had some characteristics that appear to be at odds with neoclassical econ. Specifically, economic incentives for blood donation tend to crowd out altruistic donations, resulting in less and lower quality blood supply. Another relevant article that is more in line with conventional econ theory is:
    http://www.voxeu.org/index.php?q=node/2512.

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  2. omniyat al hajeriAugust 2, 2010 at 3:19 PM

    it is even more of a challange in our region where blood donation drives are still limited in frequency and quantity,it is also a challange when we import blood and blood products!!! cost effectiveness here is even more of a crucial question.

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  3. Thanks for the other article, Maxine, and interesting insight, Omniyat.

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