title: Expensive blood safety initiatives may offer less benefit than we think.
abstract: BACKGROUND
  Various blood safety initiatives have ensured a historically low risk of infection transmission through blood transfusion. Although further prevention of infection transmission is possible through, for example, nucleic acid testing and future introduction of pathogen inactivation, such initiatives are very costly in relation to the benefit they offer. Although estimation of the cost-effectiveness requires detailed information about the survival of transfusion recipients, previous cost-effectiveness analyses have relied on incorrect survival assumptions.
  
  
  METHODS
  Based on empirical data of more than 1 million Scandinavian transfusion recipients followed for up to 20 years, we present two new survival functions. In a fictitious example we assessed the impact of survival assumptions on the estimated costs per quality-adjusted life-year (QALY) gained, by using the survival functions of three previous cost-effectiveness analyses along with the two new survival functions.
  
  
  CONCLUSIONS
  We conclude that despite considerable costs, previous cost-effectiveness studies may have underestimated the costs per QALY gained by as much as 44%.
authors.affiliation: Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark. mka@ssi.dk
authors.forename: Mads
authors.initials: M
authors.lastname: Kamper-Jørgensen
authors.forename: Henrik
authors.initials: H
authors.lastname: Hjalgrim
authors.forename: Gustaf
authors.initials: G
authors.lastname: Edgren
authors.forename: Kjell
authors.initials: K
authors.lastname: Titlestad
authors.forename: Henrik
authors.initials: H
authors.lastname: Ullum
authors.forename: Agneta
authors.initials: A
authors.lastname: Shanwell
authors.forename: Marie
authors.initials: M
authors.lastname: Reilly
authors.forename: Mads
authors.initials: M
authors.lastname: Melbye
authors.forename: Olof
authors.initials: O
authors.lastname: Nyrén
authors.forename: Klaus
authors.initials: K
authors.lastname: Rostgaard
mesh_terms: D001771:Blood Banks / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005500:Follow-Up Studies; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000191:economics / Q000401:mortality* / Q000635:transmission*; D011787:Quality of Health Care / Q000191:economics / Q000706:statistics & numerical data; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D016019:Survival Analysis