57 Past, present, and future of red blood cells Historical RBC trends Trend/Theme Drivers/Factors Definition Example quote Decreased demand of red blood cells Cost This sub-code describes how awareness of costs/cost-effectiveness related to RBC transfusions contributed to the decreased demand of it. So I think an awareness and maybe a degree of cost-shifting in some countries, including Australia, to make hospitals and even individual units and clinicians responsible for the products that they use, in the same way if we wanted to use some other very expensive product, the unit head might have to agree, and they might get billed, [and] comes out of your cost center. Surgical techniques and pharmacologic agents This sub-code describes how surgical techniques and pharmacologic agents decreased RBC demand . They’ve got quite a lot of new innovations that help minimize blood loss. Future expectations in demand Future RBC demand will decrease This code describes future expectations of how RBC will decrease or continue decreasing due to the factors listed below. So for red cells, I think it will decrease. cRBCs This sub-code describes how cultured RBCs will contribute to the reduction of RBC demand. Red cells, I think, might come down as the clinicians get better and better at controlling the use of blood. Of course, hopefully, they will eventually get replaced anyways by in vitro-generated red cells, which I don’t know how long it will take, but once the breakthroughs come I think it will accelerate very quickly. Gene therapy This sub-code describes how gene therapy will contribute to the reduction of RBC demand. So you cure the disease in fact [using] gene therapy. I really believe in it, that it can be in a large scale and it can be available for a lot of people.
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