OBJECTIVES: Patient Blood Management (PBM) is a "patient-focused, evidence based and systematic approach for optimizing the management of patients and transfusion of blood products to ensure high quality and effective patient care". It permits to mitigate the potential negative outcomes related to anemia pre- and postoperatively. PBM is based on three pillars: optimize the patients’ blood, minimize blood loss and manage patients’ anemia.

METHODS: This Budget Impact Model compares two scenarios “current clinical practice” (i.e. without PBM) and “with PBM implementation” in five surgical therapy areas (orthopedic surgery, cardiac surgery, urologic surgery, vascular surgery, digestive surgery) and from two different perspectives (Hospital and French National Payer). The model is based on an analysis of the French national hospital database (PMSI) which provides estimates of eligible population, the proportion of patients transfused, the average length of stay the proportion of anemic patients and the cost of hospitalization. These data were supplemented by the literature and validated by an expert consensus.

RESULTS: More than 2.2 million of patients could benefit from the implementation of a PBM program for the five surgical areas. From a hospital perspective, for the orthopedic surgery area that benefits roughly 1.3 million patients, the cost impact is estimated at - 427 € per patient. Indeed, PBM implementation could allow for a 17 % reduction of the mean length of stay and 77 % reduction in the total of transfused patients.

CONCLUSIONS: The implementation of a national PBM program in France will represent an improvement in health outcome and a high added value for public health thanks to reductions in transfusion rates and lengths of stay. Indeed, PBM contributes to good practices to diagnose and treat anemia, minimize blood loss and avoid unnecessary transfusions while improving patient outcomes, health standard quality of care as well as costs.