The cost-effectiveness of pathogen reduction technology as assessed using a multiple risk reduction model
Autor(es): Custer Brian, Agapova Maria, Martinez Rebecca Havlir
Resumo: Pathogen reduction technology (PRT) for labile blood components has the potential to reduce the risk of many adverse events associated with transfusion. Because of the potential broad-spectrum risk reduction capability of PRT, the health economics of PRT could be an important consideration in decision making for this technology. Decision analytic models comparing current blood safety screens - interventions to riboflavin-based whole blood PRT (currently in development) - separately to platelets (PLTs)---plasma PRT from the health care system perspective in Canada were used to assess the cost-utility of PRT in reducing the following adverse events: human immunodeficiency virus, hepatitis B virus, hepatitis C virus, human T-lymphotropic virus, syphilis, West Nile virus, bacteria, Chikungunya virus, cytomegalovirus, Trypanosoma cruzi, graft-versus-host disease, febrile nonhemolytic transfusion reactions, - transfusion-related immunomodulation. PRT was modeled as an addition to rather than a replacement for current interventions. The potential of PRT to reduce the risk of an unknown pathogen was not assessed. Whole blood PRT was estimated to have a cost-effectiveness of $1,276,000/quality-adjusted life-year (QALY; 95% confidence interval [CI] approximation, 600,000-3,313,000) compared to current screens - interventions. PLTs---plasma PRT was estimated to have a cost-effectiveness of $1,423,000/QALY (95% CI approximation, 834,000-2,818,000) on an all-transfusions basis. Because of the complexity of transfusion risks - practices, the cost-effectiveness of whole blood or PLTs---plasma PRT can be modeled provided that assumptions - simplifications are made. Uncertainty remains with respect to the risk reduction that can be achieved for some adverse events. Nevertheless, the results of this cost-effectiveness analysis can be used to inform policy decisions regarding PRT technology in the context of other initiatives designed to improve transfusion safety.
Imprenta: Transfusion, v. 50, n. 11, p. 2461-2473, 2010
Identificador do objeto digital: 10.1111/j.1537-2995.2010.02704.x
Descritores: Chikungunya Virus - Virus ; Chikungunya virus - Epidemiology ; Chikungunya virus - Public health
Data de publicação: 2010
