Télécharger le rapport (160 p.) - KCE

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KCE reports vol.12B Financement du sang 4 1.2 COMPARISON OF FEE PER BLOOD COMPONENT DELIVERED Table 1. Comparison of fee per blood component (in €) Blood component Austria Belgium England Finland France Germany i Ireland Norway Northern Ireland Portugal Switzerland Erythrocyte concentrate --- ii 68 iii --- --- --- --- --- --- --- --- --- --- Leukodepleted 112 93 182 93 171 75 250 175 144 96 123 186 Random donor platelet concentrate --- --- --- --- --- --- --- --- --- 69 --- --- Leukodepleted --- 42 iv --- 35 v 50 75 vi --- --- --- 78 vii 100 81 viii Single donor platelet concentrate --- --- --- 76 --- --- --- 109 --- --- --- --- Leukodepleted 455 383 301 --- 406 500 550 794 625 280 354 420 794 Fresh frozen plasma --- --- 47 72 --- --- --- --- 52 67 --- --- Virus inactivated 68 75 90 --- 112 --- 128 55 --- --- 97 --- After quarantaine 56 75 --- --- 67 45 60 --- --- --- 78 97 160 i One Länd only ii --- denotes not available iii No longer available as of 1/1/2005 iv per 0,5 X 1011 platelets v supplement for leukodepleted pool (therapeutic unit): 45.8 € vi Per therapeutic unit: 295€ vii Per pool of 5 buffycoat (therapeutic unit): 394€ viii Per donor unit The Netherlands
KCE reports vol. 12B Financement du sang 5 Prices of leukodepleted erythrocyte concentrates show a great variation and range from 75€ to 250€. Nevertheless, these prices can not be easily compared because it is not clear if cost components included in prices are similar in every country. For example, Belgium is in the low range with 93 €, but the Belgian price does not include the cost of the NAT b tests, which are reimbursed at cost to the Belgian blood services through a separate subsidy. Prices of leukodepleted single donor platelet concentrates can not easily be compared either, as some countries reimburse per donor unit, whereas other countries reimburse per number of platelets. For all products compared, Belgian fees are consistently lower than the average / median of prices in the other European countries (see table 2). Table 2. Fee per blood component (€): Belgian prices compared to the mean / median of the prices in the other countries c . Blood component Belgium Mean Median % of Mean % of Median Erythrocyte concentrate leukodepleted 87 125 124 70 70 Random donor platelet concentrate, leukodepleted 39 60 58 60 58 Single donor platelet concentrate, leukodepleted 358 426 413 84 87 Fresh frozen plasma virus inactivated 70 76 70 92 100 After quarantaine 70 76 70 92 100 1.3 FEES DETERMINATION METHODOLOGY Little information was received on the mechanism of determination of the fees. In England, a national commissioning group was established in 1998 to oversee the setting of national prices for blood and components. On the group sit representatives from the National Blood Service, Department of Health, NHS Trust hospitals and NHS Strategic Health Authorities. The group agrees the National Blood ServiceÊs product unit prices each year, in a process taking a view on funding of approved developments (especially in the area of blood safety), efficiency saving targets, and inflation and capital costs associated with the National Blood Service capital programme. In Finland, fees are determined each year by the blood service. In Norway, fees are determined jointly by the blood service and the social health care insurers, every two or three years (as there is no standardization of the price of blood components, there may be some variation from place to place). In both countries, fees readjustment takes into account index changes and additional requirements as new testing. In Luxembourg, fees are negotiated between the Social Security and the Blood Service and are approved by the Minister of Health. They are often, but not necessarily, determined each year and are calculated on the basis of the last available cost evaluation. An increase of 2% per negotiation is generally accepted. In the Netherlands, blood products are delivered to hospitals through Sanquin, the Dutch Blood Service. Tariffs of the different blood products are based on integral cost accounting by Sanquin, and approved yearly by the Minister of Health. b NAT testing ( Nucleid Acid Amplification Technology testing), is used to detect very recently infected donors during the pre-seroconversion "window period" of infection, essentially for hepatitis C and HIV. c Prices weighted with comparative price levels index. Comparative price levels are defined as the ratios of purchasing power parities (PPPs) to exchange rates. Source: OECD 2004
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KCE reports 1. Efficacité et renta
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