Is blood really free?

By Damu Sasa

Blood donation is voluntary and non-remunerated, at least in Kenya. This is according to the Ministry of Health (MoH)’s current policy on blood transfusion. Over time, this has helped to fuel the notion that donated blood ought to be free of charge to the recipients.

Rather unfortunately, this is not the case. In the least, one unit of blood costs KES 10,000. This is according to a Business Daily article titled ‘Broke blood banks push Kenyans to social media,’ published on 2nd February 2020. The price point however, varies from hospital to hospital and in some cases, the price can be upwards of KES 70,000/-.

The big question is where do these costs come from if at all blood is freely donated?

Once donated, blood becomes a medical commodity like any other. It is subject to processing, inventory handling and distribution. All these have related costs.

First, donated blood is harvested into a blood bag. According to the ‘Made-in-China’ ecommerce website, one blood bag costs roughly KES 50 – 80.

Second, to ensure that donated blood is absolutely safe for transfusion, it must be thoroughly screened. Here, the blood group is established, alongside verifying that it is disease free. This involves the use of equipment and chemical reagents that have to be either bought, restocked, or routinely maintained. For example, one set of haematology analyzer reagents costs between KES 3,000 to 8,000, on the Alibaba e-commerce website.

Third, donated blood needs to be stored in a temperature-controlled environment. This is in order to maintain its integrity and, therefore, usability. This then carries with it the cost of refrigeration and handling, to name but a few.

Fourth, there is the cost of logistics and transportation of donated blood to hospitals, the last mile. This then has vessel and fuel implications.

Then there are the professional staff costs. From the blood donor attendants, who aid in safe blood harvesting, to the lab staff who conduct screening and proper storage, and all the way to those who monitor actual transfusion. Sadly, their level of effort is mostly overlooked in calculations.

So, to the question, “Is blood really free?” Yes, it is! No one charges the patient for the commodity itself. The service charges are merely an upward transfer in the interest of sustainability.

Therefore, the next time you question why blood is not free, please remember this article. Fortunately, there is a growing push by many stakeholders for the National Hospital Insurance Fund (NHIF) to begin reimbursing costs associated with blood services in order make blood more affordable. However, this is yet to be accomplished.

Last but not least, there is growing evidence that blood is also subject to the power of demand and supply. Due to our weak blood donation culture, which is at less than 10% for adults, blood has been rendered a ‘rare’ commodity. This may tempt facilities to charge a higher price to meet the demand.

Regular and voluntary donations can address the issue of supply and demand, and hence mitigate against the tendency to be in a scarcity situation. This way, we can reduce the chances that someone might charge higher prices because of high demand.

Damu Sasa is an innovative end-to-end blood services information platform built to aid in the effective management of blood services.

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