The sustainable availability of safe blood and blood products is a fundamental pillar of public health systems.

The World Health Organization (WHO) model for costing blood products, published in 2025, proposes a standardized methodology based on activity-based costing that allows for a comprehensive estimate of the costs associated with blood establishments, hospital transfusion services, and plasma collection centers.

This article synthesizes and analyzes in depth this model from a public health perspective, integrating recent scientific evidence on transfusion economics, patient blood management and financial sustainability of health systems. Its implications for the formulation of public policies are discussed,
budget planning and ensuring equitable access to safe and quality blood products.

Universal access to safe blood and blood products is an essential component of health systems. The World Health Organization (WHO) has emphasized that the availability, safety and quality of blood products depend on coordinated, sustainable and adequately funded national blood systems. However, one of the main challenges identified at a global level is the lack of reliable information on the real costs associated with the provision of these services.

In response to this gap, the WHO updated its costing model originally published in 1998 in 2025, incorporating technological advances, greater regulatory demands and the increasing complexity of modern blood systems. The WHO model for costing of blood products offers a comprehensive methodological framework for estimating costs in blood establishments, hospital transfusion services and plasma collection centers.

The sustainability of national blood systems depends, to a large extent, on the ability of countries to accurately estimate the costs associated with the provision of safe, quality blood products. Historically, the absence of standardized methodologies has limited financial planning, accountability and evidence-based decision making in blood services.

Blood and blood products are strategic and irreplaceable inputs for modern health systems, essential for maternal, neonatal, surgical, oncological, trauma and emergency care. From a public health perspective, guaranteeing its timely availability, biological safety, quality and financial sustainability constitutes a non-delegable responsibility.

However, many countries, particularly low-incomeand medium, face structural limitations to accurately estimate the real costs associated with the provision of blood and transfusion services.

Historically, the absence of standardized costing methodologies has hindered financial planning, efficiency assessment, and accountability in national blood systems. In this context, the update of the WHO model in 2025 represents a significant advance by incorporating modern health economics approaches, greater technological complexity and international regulatory requirements.

What is the proposed costing model?

The model is based on activity-based costing (ABC), a methodology that allows you to accurately identify how resources are consumed by specific activities within an organization. Unlike traditional approaches, ABC facilitates the allocation of indirect and overhead costs, which represent an increasing proportion of total spending on blood services.

A methodology widely used in health economics to accurately allocate resources consumed by specific processes. Unlike traditional global costing models, ABC allows you to more accurately identify the direct, indirect and general costs associated with each stage of the blood system.

The WHO defines five fundamental activities of the blood system:

1. Donor recruitment and retention
2. Blood and plasma collection
3. Laboratory tests and quality control
4. Processing of blood components
5. Storage and distribution

Each activity integrates capital costs and recurring costs, allowing a detailed and comparable estimate between institutions and countries.

Classification and cost analysis

a. Capital costs

They include long-term investments such as infrastructure, biomedical equipment, information systems, vehicles and initial staff training. The model incorporates depreciation as a mechanism to reflect the economic wear and tear of assets throughout their useful life.

b. Recurring costs

They correspond to ongoing operating expenses, including salaries, supplies, diagnostic reagents, maintenance, public services, transportation, quality management and waste disposal. A distinctive aspect of the model is the inclusion of “hidden” or unbudgeted costs, common in hospital blood banks.

The OMS model also incorporates non-monetized costs, such as volunteer staff time or shared infrastructure, allowing for a more comprehensive economic estimate.letter and realistic.

Applicability in different operating environments

The model recognizes the heterogeneity of blood systems and allows its application in:

– Centralized or decentralized blood establishments
– Hospital transfusion services
– Plasma collection centers for fractionation

Likewise, it incorporates the analysis of compliance costs (Cost of Conformance, COC) associated with compliance with international standards, particularly relevant for the production of plasma for plasma-derived medicines.

The WHO costing model constitutes a strategic tool for the formulation of public policies aimed at the self-sufficiency and sustainability of national blood systems. By providing detailed and comparable cost information, the model facilitates the efficient allocation of resources, prioritization of investments, and evaluation of the economic impact of regulatory and technological interventions.

Recent scientific evidence (2025) demonstrates that the implementation of patient blood management programs (Patient Blood Management) significantly reduces the inappropriate use of transfusions, reduces hospital costs and improves clinical outcomes, without compromising patient safety. These strategies complement the WHO model by integrating clinical decisions with economic analysis.

Implications for management and public policy

The WHO model is not limited to cost estimation, but is a strategic tool to:

– Evidence-based budget planning
– Evaluation of efficiency and productivity
– Comparison and benchmarking between institutions
– The justification of investments before health authorities and financiers

Its comprehensive economic approach facilitates decision-making aimed at the sustainability and self-sufficiency of national blood systems.

The WHO model focuses on its applicability, flexibility and ability to generate reliable data that transforms the financial management of blood services, moving from decisions based on limited information to management based on economic and operational evidence.

By enabling accurate cost analysis, it helps justify budgets, implement cost recovery systems, and ensure the long-term financial viability of blood programs, something that lack of datadetailed currently prevents.

Conclusion

The WHO model for costing of blood products represents a significant advance in the standardization of the economic analysis of blood services. By integrating activity-based costing with a systemic view of the transfusion process, the model strengthens the capacity of countries to ensure equitable access to safe, quality and financially sustainable blood products.

Integrating the WHO model with modern transfusion economics approaches allows for a holistic view of the blood system as an essential public good. The standardization of costing facilitates international comparison and benchmarking, key elements to strengthen governance and transparency in public health.

This is why the WHO model constitutes a robust, flexible and standardized tool that strengthens financial planning, efficiency evaluation and sustainability of blood systems. Its implementation favors informed decision-making, the design of realistic budgets and the mobilization of resources, especially in low- and middle-income countries.

The World Health Organization model for costing blood products represents a substantial advance for public health by providing a rigorous, standardized and adaptable methodological framework for cost estimation in blood systems. Its application strengthens financial planning, evidence-based policy formulation and the sustainability of national blood systems, helping to guarantee equitable and safe access to transfusions for the population.

Reference

World Health Organization. (2025). WHO model for costing of blood products. World Health Organization. https://iris.who.int/