OBJECTIVES: Platelet transfusions (PT) are commonly used as prophylaxis in patients with thrombocytopenia (TCP) before an invasive procedure, in order to reduce the risk of hemorrhage. The full cost of PT in Italy is not well documented in the literature. The aim of this study is to generate a comprehensive estimate of the costs of platelets in Italy, with a focus on patients with Chronic Liver Disease (CLD) and severe TCP, undergoing an elective procedure.

METHODS: The cost analysis consisted of three steps: i) identification of all activities and resource consumption associated to PT; ii) collection of unitary costs for each relevant resource consumption; iii) estimation of overall costs per transfusion per average patient. The study adopts the NHS perspective. Evidences were collected from published literature, public reports and national legislation and were validated by Italian physicians to better reflect the national practice.

RESULTS: All costs associated with PT were classified into three groups: donation, transfusion and blood components. The total mean direct costs associated to single-unit PT were estimated at €357: this estimate included donation costs (~15%), administrations costs (~17%) and mean costs of platelet units (~68%). The total costs associated to PT were higher in patients with CLD and severe TCP undergoing an elective procedure (€1,463 per patient), reflecting the higher number of platelet units used to restore acceptable platelet levels (i.e. 4-5 units/patient) and minimize the risks of bleeding.

CONCLUSIONS: PT represents a substantial economic burden in patients with thrombocytopenia. In an environment of limited healthcare resources, having comprehensive information on PT transfusion costs is crucial for healthcare organizations. Upcoming pharmaceutical options in this setting can help save time and optimize resource consumption. Measures to decrease PT-related costs may include implementing management algorithms, updating guidelines or protocols to include appropriately licensed treatment alternatives.