Discussion

Abstract

A. Laupacis, Ottawa, C: I listened to dr. AuBuchon’s superb talk. He indicated that a lot of economic evaluations of technologies in the transfusion area have shown that they are highly cost-ineffective compared to other interventions. Yet we seem to be ignoring this information in health policy. One reason might be that, in Canada at least, I think part of transfusion medicine has functioned more or less outside the conventional health care system. So, when blood is ordered by a clinician, the clinician tends not to think about the costs of blood since the hospital does not pay for it. 1 wonder whether more attention needs to be paid in these economic analyses to whom actually pays for the blood. The second issue is that because we understand how much we as a society pay for blood, people tend not to pay that much attention to the increased aggregate costs of blood transfusion.