title: Cost-effectiveness of leucoreduction for prevention of febrile non-haemolytic transfusion reactions.
abstract: BACKGROUND
  The cost-effectiveness of universal leucoreduction of blood components remains unclear. When using leucoreduced red blood cells, the decrease in the rate of febrile non-haemolytic transfusion reactions (FNHTR) is the only proven, meaningful clinical benefit, whose relationship to costs can be calculated relatively easily. The aim of this study was to evaluate the cost-effectiveness of leucoreduction in avoiding FNHTR.
  
  
  METHODS
  Data were obtained from two large tertiary hospitals in Athens, Greece, over a 4-year period (2009-2012). The incidence of FNHTR in patients transfused with leucoreduced or non-leucodepleted red blood cells, the additional cost of leucoreduction and the cost to treat the FNHTR were estimated. The incremental cost-effectiveness ratio (ICER), which is the ratio of the change in costs to the incremental benefits of leucoreduction, was calculated.
  
  
  RESULTS
  In total, 86,032 red blood cell units were transfused. Of these, 53,409 were leucodepleted and 32,623 were non-leucoreduced. Among patients transfused with leucodepleted units, 25 cases (0.047%) met the criteria for having a FNHTR, while in patients treated with non-leucoreduced components, 134 FNHTR were observed (0.411%). The ICER of leucoreduction was € 6,916 (i.e., the cost to prevent one case of FNHTR).
  
  
  CONCLUSIONS
  Leucoreduction does not have a favourable cost-effectiveness ratio in relation to the occurrence of FNHTR. However, many factors, which could not be easily and accurately assessed, influence the long-term costs of transfusion. It is imperative to undertake a series of large, meticulously designed clinical studies across the entire spectrum of blood transfusion settings, to investigate most of the parameters involved.
authors.affiliation: Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Argirios E
authors.initials: AE
authors.lastname: Tsantes
authors.affiliation: Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Elias
authors.initials: E
authors.lastname: Kyriakou
authors.affiliation: Hellenic Centre for Disease Control and Prevention, Athens, Greece National Development and Research Institutes Inc., New York, NY, United States of America.
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Nikolopoulos
authors.affiliation: Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Stylos
authors.affiliation: Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Marlene
authors.initials: M
authors.lastname: Sidhom
authors.affiliation: Department of Pharmacology, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Stefanos
authors.initials: S
authors.lastname: Bonovas
authors.affiliation: Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Douramani
authors.affiliation: Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kalantzis
authors.affiliation: Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Styliani
authors.initials: S
authors.lastname: Kokoris
authors.affiliation: Laboratory of Haematology and Blood Bank Unit, Aretaieio Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Serena
authors.initials: S
authors.lastname: Valsami
authors.affiliation: Hellenic National Blood Centre, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stamoulis
authors.affiliation: Laboratory of Haematology and Blood Bank Unit, Aretaieio Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Marianna
authors.initials: M
authors.lastname: Politou
authors.affiliation: Blood Transfusion Centre, General Hospital of Nikaia, Athens, Greece.
authors.forename: Leontini
authors.initials: L
authors.lastname: Foudoulaki-Paparizos
mesh_terms: D003365:Costs and Cost Analysis; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000191:economics* / Q000379:methods*; D005260:Female; D006801:Humans; D047589:Leukocyte Reduction Procedures / Q000191:economics* / Q000379:methods*; D008297:Male; D012189:Retrospective Studies