#OA1-AM25-ST-22 - Are Improvements in Inventory and Patient Blood Management Sufficient? An Analysis of past Performance to Target Realistic Blood Product Budgeting for the Coming Fiscal Year

Saturday, October 25, 2025

1:45 PM - 2:45 PM PT

Room: SDCC 30AB

Presenting Author(s)

Jessica L. Jacobson, MD

Laboratory Director and Chief of Pathology
NYC H+H/Bellevue & NYU Grossman School of Medicine
New York, New York

Disclosure information not submitted.

Background/Case Studies: With the expected cuts to Medicaid and governmental spending, establishing a realistic budget is more important than ever. To effectively budget, it is crucial to review past performance, understand clinical needs, and forecast expenses. From 2020 to 2024, US inflation saw a significant increase, peaking at 7% in 2021 before cooling to roughly 3%. During the same time frame, our system grew 20+% to 1.27 million inpatient days. The blood banks were tasked to improve inventory management, reduce wastage, and assure appropriateness of transfusions. To estimate our ability to achieve the budget neutral target set for us in the coming fiscal year, we sought to evaluate the if the improvements in our inventory management practices and patient blood management program would be sufficient.

Study

Design/Methods: We performed a retrospective analysis of all SDPs and RBCs purchased, transfused, and wasted by each hospital within our system in 2020 (20) and 2024 (24). Pre-transfusion platelet counts and hemoglobin levels were used to assess appropriateness of the transfusions. Results were assessed using the Student’s T-test.

Results/Findings: In 20 8146 SDPs were purchased, 4335 were transfused, and 2150 were wasted. In 2024 7804 SDPs were purchased, 5858 were transfused, and 1683 were wasted. The average cost per SDP unit was $520.99 in 20 and $645.16 in 24. 35.8% more SDPs were transfused in 24 than 20. Patients transfused SDPs had a statistically significant lower mean pre-transfusion platelet count of 66.78 µL vs 71.30 µL (p-value < 0.005) in 24 than 20. In 20 40652 RBCs were purchased, 37722 were transfused, and 1816 were wasted. In 24 45956 were purchased, 43527 were transfused, and 1683 were wasted. The average cost per RBC unit was $210.26 in 20 and $223.76 in 24. 14.8% more RBCs were transfused to patients in 24 than 20. Patients transfused RBCs had a statistically significant lower mean pre-transfusion hemoglobin level of 7.3417 g/dL vs 7.3889 g/dL (p-value < 0.003) in 24 than 20. Discards decreased by 21.7% (p-value=0.06) for SDPs and 10.6% (p-value=0.39) for RBCs yielding a savings of $34324 for SDPs and $18456 for RBCs. The spend however increased by 18.6% for SDPs and 20.3% for RBCs.

Conclusions: Despite a 3.5% decrease in discards and improvement in transfusion appropriateness, inflation and greater clinical demand for blood products resulted in 19.8% increase in spending from $12.8 million in 20 to $15.3 million in 24. With the 6.2% contractual price increase for blood products in the next fiscal year, more aggressive measures to further reduce wastage and assure transfusion appropriateness will be required to meet our budget neutral target.