Expensive blood safety initiatives may offer less benefit than we think.
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%.
Kamper-Jørgensen
Mads
M
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark. mka@ssi.dk
Hjalgrim
Henrik
H
Edgren
Gustaf
G
Titlestad
Kjell
K
Ullum
Henrik
H
Shanwell
Agneta
A
Reilly
Marie
M
Melbye
Mads
M
Nyrén
Olof
O
Rostgaard
Klaus
K
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