DEPARTMENT OF HEALTH AND HUMAN SERVICES ADVISORY COMMITTEE ON BLOOD SAFETY AND AVAILABILITY MONITORING THE SUPPLY AND DEMAND FOR BLOOD PRODUCTS

DEPARTMENT OF HEALTH AND HUMAN SERVICES
ADVISORY COMMITTEE ON BLOOD SAFETY AND AVAILABILITY
MONITORING THE SUPPLY AND DEMAND
FOR BLOOD PRODUCTS
August 24, 2001
STATEMENT OF THE AMERICAN RED CROSS
Jacquelyn Fredrick
Senior Vice President, Biomedical Services

Mr. Chairman and Members of the Advisory Committee:
The American Red Cross is committed to developing a stable and sustained blood supply to meet increasing patient needs and hospital demand for these life-saving products. We believe it is incumbent upon the blood banking and transfusion medicine community to commit to a new way of doing business by accurately forecasting the demand for blood and ensuring that blood collections are geared to meet specific patient needs. The Red Cross has instituted a series of new initiatives that are enhancing our ability to monitor the amount of blood collected, distributed, and in inventory at the blood center and nationally. With this information, along with the results of market research that enhances our understanding of how to effectively reach generous blood donors, we are working to make chronic cyclical shortages a thing of the past.
We have been asked to comment on HHS' plan to monitor the demand for blood products. We believe in order to ensure blood availability, it is critical to have an effective means for monitoring hospital and patient needs as well as available inventory. The recent announcement by HHS regarding a sentinel system with real time information from 29 hospitals on supply and demand for blood and blood products will be useful for all of us in the blood services enterprise.
At the April meeting of this Committee and at the June meeting of the Transmissible Spongiform Encephalopathy Advisory Committee (TSEAC), the Red Cross shared with the Department of Health and Human Services (HHS) our short and long term plans to increase blood collections. Today we are pleased to share with the Committee and our blood services colleagues the initial results of our efforts to monitor and increase the blood supply as well as our comments on the present HHS data collection effort.
Anticipated Impact of vCJD Donor Deferral
Before I outline our recent activities and results, we would like to update the Committee on research to determine the further impact of our expanded donor deferral criteria relating to variant Creutzfeldt Jakob disease (vCJD). This information is directly relevant to blood availability.
The Red Cross commissioned Wirthlin Worldwide to perform a telephone survey of a nationally representative sample of Red Cross donors to determine the number of individuals that would be deferred because of our expanded vCJD criteria. The findings of this survey indicate a total of 3% of all current Red Cross donors will no longer be eligible to donate under our expanded guidelines (with a margin of error of 0.6%). Approximately 1% of eligible donors will erroneously self-defer, even though they are actually eligible to donate. Taken together, the results of the survey indicate that about 4% of our donors (+ or - 0.6%), or approximately 235,000 units may be lost to this expanded deferral (see attachment #1).
Based upon our collections experience this July and forecasted collections through mid-September the Red Cross believes that donations will cover this anticipated loss. Although the Wirthlin survey shows the Red Cross national system experiencing a loss of between 3-5%, our collection goals are based on prior modeling that indicated an 8% loss in donors. The Red Cross is working hard to ensure an adequate blood supply to our hospital customers. Our recent summer initiatives have already shown positive results toward increasing blood collections.
Recent Initiatives and Increased Collections
There are those who have speculated that donations are actually decreasing in this country. We have found the opposite. In fact, presenting donors to the Red Cross surged to 7.5 million in FY 2001, a 6.1% increase compared to FY 2000. This corresponds to an 8.5% gross increase in productive units when one uses FY 2000 deferral rates that do not include our losses due to finger sampling. This corresponds to over 543,294 more units of blood in FY 2001 (see attachment #2).
The Red Cross has seen an increase in our blood collections for this summer compared to the past. We embarked on a targeted advertising campaign, personal contact with our donors and new programs to monitor and forecast blood collections and distributions. Our July 2001 collections of 551,949 reflect a 7.8% increase over July 2000. That's over 39,000 more units of blood in just one month, equivalent to about a 2 day transfusion need. Thirty-one of our 36 regions collected more blood this July than last July.
These increased collections have had a direct impact on our inventory. Our total red cell inventory is 33% higher this August than last year. Type O inventory increased by 83% over last August. This shows that our targeted efforts to contact O donors has paid off. Distributions of red cells are up 3.5% this July compared to last July with a comparable increase in Type O distributions.
Our recent campaign highlights our ability to increase blood collections by using the right strategy and resources. Our goal is to make this sustainable.
Long-Term Initiatives
We are moving forward with longer-term initiatives to build upon our positive experiences this summer, the lessons learned and what we are hearing from our donors. We are increasing our collection staff, collection sites, and collection goals. We are developing specific appointment scheduling methods that will expedite the donation experience and are planning to expand our telemarketing and call management systems as well as improving the BDR process. All of these initiatives are geared to making the donation experience quicker and more enjoyable for the volunteer blood donors on whom we depend.
The Red Cross is also working on its projection and demand models so we can forecast where blood is needed before there are any shortages. We have been forecasting collections for over a year and we believe our models will continue to accurately predict what we can collect.
HHS Monitoring Effort
All of us in blood services are challenged by meeting growing patient needs for lifesaving blood. Chronic, cyclical blood shortages have long plagued this enterprise. HHS' announcement about the sentinel system for monitoring the blood supply is commendable. This is a good step toward better understanding issues of the blood supply and the need for blood in the 29 participating hospitals. This information will be useful to everyone in blood services and will provide a "snapshot" of certain variables that impact the supply of blood.
Conclusion
The Red Cross would like to thank the Committee for the opportunity to provide our views on these important public health issues. The safety of the blood supply and its availability are the top priorities of the Red Cross. We believe it is the shared responsibility of blood collection organizations and hospitals to collect data on supply and demand and institute programs to ensure blood availability.