Cost of Blood Products in Iran: A Case Study of the Shiraz Blood Transfusion Organization Using Activity-based Costing

Background: Although blood is donated rather than purchased, collecting, storing, and testing it for viral markers is expensive. During the Cost of Blood Consensus Conference (COBCON), activity-based costing (ABC) was proposed as a standard way to figure out the cost of preparing a unit of blood. Objectives: The ABC can be used by any organization that pays for blood or blood products. It was used to determine how much each unit of allogeneic blood costs in Iran, considering the limited blood sources and the importance of cost evaluation studies. Methods: This cross-sectional, descriptive-analytical study was conducted at Shiraz Blood Transfusion Organization in 2020-2021 (Shiraz, Iran). We used the ABC method to determine how much each unit of allogeneic blood costs in Iran. In this study, activity centers were divided into high-level, intermediate, and final activity centers. The resources of each activity center were made up of human resources, consumables, buildings, equipment, and energy. Results: Direct and indirect costs of producing blood were separately investigated in the studied sub-units. The final estimated cost of preparing one blood unit was almost 13 million IRR (≈308 USD). According to our findings, indirect costs comprised a significant portion (86.45%) of the cost of producing a unit of blood, while direct costs accounted for only 13.55%. Conclusion: As evidenced by the obtained results, the cost of one blood unit was far more than the national average estimated by the Iran Blood Transfusion Organization. There is a need for additional research on the cost of other blood products and indirect cost reduction strategies.