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The Blood Supply

Blood Collection

Blood donation chairsBlood in the U.S. is collected by FDA-licensed collection centers. Approximately half of the blood is collected by the American Red Cross, and the other half by independent collection centers loosely banded by an organization known as America's Blood Centers (formerly the Council of Community Blood Centers). Hospital blood banks acquire their supplies from regional blood centers, whether Red Cross or independent.

Often, there are competing blood suppliers in a given region so that hospital blood banks can obtain supplies from more than one source. This can become a little tricky, though, since blood banks are forced to balance commitment to a single supplier for lowest pricing against the need to maintain necessary supplies. Hospital blood banks may also supplement their supply by acquiring blood from distant collection centers (i.e., out-of-state suppliers) as well as by in-house collections. Hospital-based donor collection sites are also regulated by the FDA.

Blood donationThere is no uniform set price for blood, the cost varying from region to region as well as from center to center. To understand pricing of blood, however, one must understand what is meant by the term "blood." Whole blood (i.e., a pint of blood), once collected, is separated into its three main components: red blood cells (oxygen-delivering cells), platelets (clot-forming cells), and plasma (non-cellular portion containing clotting factors). Sometimes a fourth component called cryoprecipitate (a fraction of plasma highly concentrated in some clotting factors such as Factor VIII or antihemophilic factor, fibrinogen, and von Willebrand factor) is also generated. Thus, from a single blood collection, up to four blood components may be processed and sold.

The most expensive component is the red blood cells (RBCs). The price of a unit of RBCs itself depends upon a number of factors (besides the supplier), including the blood type (type O, universal-donor blood usually being more expensive) and whether the unit has any special attributes required by the intended recipient; such as, white-blood-cell reduction (a technique used to remove contaminating white blood cells), special-antigen typing (necessary when the intended recipient has become sensitized to certain RBC antigens as a result of prior RBC transfusion or, occasionally, pregnancy), or other attributes, all of which add to the price.

Currently, the average base price of a unit of RBCs is in the range of $100-$160, but will increase as more sophisticated testing for transmissible diseases (e.g., HIV and viral hepatitis) are introduced. The cost of RBCs to the hospital blood bank may be partially offset, though, through the purchase of non-red cell components, depending on the supplier contract.

-- Dr. Neville Colman
Chairman of Pathology
Continuum Health Partners

-- Dr. Mark Friedman
Associate Director of the Blood Bank
St. Luke's/Roosevelt Hospital Center

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