I had made this statement earlier in this thread:
By the way, I doubt the blood transfusion ban will be going away anytime soon - after a history of increases in stock value, the company is in a bit of a slump and is experiencing a little hiccup in stock value right now. If the JW blood ban was lifted completely, Haemonetics' stock would surely dip even more. Brian Concannon just sold off a chunk of his stock - maybe he needed the cash to keep his hands green.
Haemonetic technology has been around a long time - its first success was built on stem cell harvesting which was late 60s, early 70s. The cell saver development has had many hiccups and controversy around its use. It has emerged as benefical in many different surgical procedures and is commonly used in surgical settings.
However, its best use is in conjunction with allogenic blood, not as a sole blood recycling machine. So, the medical benefits have been established, along with the ways it isn't useful. Blood management programs are dependent, to a large degree, upon technology that is produced by Haemonetics, and other companies like it. One of the strategies adopted by Farmer et al - Axel Hoffman, the JW financial guru - in Australia to push the SABM standard into the country's health care system, was to heavily emphasize the cost savings. Blood management became a profit-based model, and improved patient outcomes were murkily termed "evidence-based".
Cell saver technology has been an integral part of surgical environments now - many "gifted" to hospitals by donors or the company itself, for research purposes. The Netherlands is one country that has been using blood saving technology for some time now, long enough to determine that cell savers and the use of erythropoietin are not cost effective in hip and knee surgery.
Despite evidence that erythropoietin and intra- and postoperative blood salvage are expensiveNot everybody buys into the bloodless industry's promises. Yes, there are benefits and much good to had with the management and development of blood technology, but I like what this doctor had to say about blood management programs:http://www.hhnmag.com/Magazine/2012/Sep/0912HHN_FEA_Trending
techniques considered to be non-cost-effective in primary elective total hip and knee arthroplasties in the
Netherlands, Dutch medical professionals use them frequently to prevent the need for allogeneic transfusion.
To actually change physicians’ practice, a tailored strategy aimed at barriers that hinder physicians in abandoning
the use of erythropoietin and perioperative blood salvage was systematically developed. The study aims to examine
the effectiveness, feasibility and costs of this tailored de-implementation strategy compared to a control strategy.
Richard Benjamin, M.D., chief medical officer of the American Red Cross, says he agrees there's reluctance to change long-standing medical tradition when it comes to restricting transfusions. He's also not convinced blood management programs save money.I wonder if the Netherland's study, and the decision to reduce the use of cell savers and erythropoietin, concluding that they are not cost effective procedures in hip and knee surgery, will have an impact on the bloodless industry.
To do them properly, he says, hospitals may need to purchase an IT system that can crunch the data and tell administrators who is using the blood and whether the use is appropriate.
Hospitals also need to add anemia clinics, he says, and even if they are willing to spend the money, the decision to start blood management can take years.
However, Benjamin says, the reason to start a blood management program should not be based on the bottom line or fear that blood isn't safe. Blood used incorrectly can harm, and blood used correctly can be life-saving, he stresses, and starting a blood management program just to save money is a dangerous approach.
"There are consultants out there who go to hospitals and say you should be doing patient blood management because it will save you money. Or you should be doing patient blood management because blood is bad, dangerous and kills patients. I don't subscribe to either of those," Benjamin says. "If you do this properly, you can conserve resources, you can treat patients better, the outcomes are likely to be better.
Remember that doctor on the Awake magazine, the guy in green scrubs who endorsed bloodless surgery? Peter Earnshaw. He was a UK orthopedic surgeon who explored the use of cell savers in his early research and was intrigued with the possibilities it could offer orthopedic surgery because of the high blood loss often associated with it. He did not, however, see it as something to be used solely and without allogenic blood being used as well. In Earnshaw's opinion, cell savers were useful, but not primarily so.
Haemonetics got its start by "gifting" their technology to hospitals and research centers. Now, they may have a difficult time justifying the cost factor for general use. Sure...they can recycle blood, but the supporting infastructure of that recycling has yet to hold up to the claims that it saves money. Time will tell. The "Golden Standard of Care" may cost more gold than it is worth.
