US prehospital blood model estimates 540 million dollars before additional costs

The U.S. supply and operating model

Young and colleagues model 225,000 prehospital transfusions per year at this deployment level, with 982,000 units shipped and approximately 1.1 million units collected. The model estimates 550,000 donors. Training, staffing, data systems, refrigeration equipment and regulatory compliance are excluded from the product budget. A fully costed transport, rotation and disposal service is not established. Replacement purchases are included through annual shipments. [1]

Unused blood requires frequent management. The modeled usable period on EMS vehicles is 16 days without hospital rotation, or nine days before rotation. Approximately 551,000 units are transferred to hospitals in the rotation scenario. These transfers are not discarded blood. Funding product purchases alone does not organize the complete supply process. [1]

Donor availability creates a separate constraint. The American Red Cross declared national blood supply crises in January 2022 and July 2026, twice in less than five years. Its July 2026 announcement reported critically low type O supplies and restrictions on hospital distributions. Expanding low-titer group O whole-blood collection therefore requires qualified donors from a supply already under pressure. Group O whole blood still requires appropriate donor selection and transfusion protocols. [2]

Our BHOC planning scenario

Our illustrative BHOC calculation uses the same 225,000 annual treatment opportunities, with two BHOC cartridges per treatment procedure. This gives 450,000 cartridges annually. Stocking two cartridges on each of 21,000 vehicles adds an initial reserve of 42,000, bringing first-year requirements to 492,000 cartridges.

* This scenario assumes validated storage without a cold chain and no expiry-driven replacement during the modeled period. Subsequent procurement follows use rather than the blood model's short rotation intervals. Manufacturing reserves and other losses would be additional. These are planning assumptions, not an established BHOC dose, a sales forecast or evidence of clinical equivalence to whole blood. No BHOC price is assigned.

The oxygen-delivery bridge

BHOC, Biological Hemoglobin Oxygen Carrier, is being developed as a bridge solution for one critical function: timely delivery of oxygen to tissues. Donor blood remains necessary when its other functions are required. This operational comparison does not quantify transfusion complications or compare the efficiency of tissue oxygen delivery.

A separate research question in myocardial ischemia

The physiological question extends beyond hemorrhage. During myocardial infarction, normal circulating hemoglobin does not guarantee adequate oxygen delivery to ischemic tissue. Microvascular dysfunction can impair tissue perfusion even after a coronary artery is reopened. Early tissue oxygenation is time-critical because injury progresses while oxygen delivery remains inadequate.

Our published architectural description uses 'more than 400 times smaller than a red blood cell' as a conservative comparison of linear dimensions in the polymerized-hemoglobin design space. Final size remains formulation-specific. We believe a controlled cell-free carrier may support oxygen delivery through plasma-accessible microvascular pathways where residual perfusion persists. Small size alone does not demonstrate restoration of perfusion or tissue protection. [3]

We aim to investigate whether an oxygen-delivery bridge can sustain threatened tissue and limit ischemic damage and subsequent reperfusion injury. Historical HBOC-201 research preserved myocardial oxygenation and ventricular function in swine during brief coronary occlusion using preoxygenated material infused through a catheter distal to the obstruction. That specific experiment supports further investigation. Prevention of myocardial injury with BHOC remains a clinical research question. [4]