title: Cost-utility and budget impact of methylene blue-treated plasma compared to quarantine plasma.
abstract: Methylene blue and visible light treatment and quarantine are two methods used to reduce adverse events, mostly infections, associated with the transfusion of fresh-frozen plasma. The objective of this study was to estimate and compare the budget impact and cost-utility of these two methods from a payer's perspective.
  
  
  
  A budget impact and cost-utility model simulating the risks of hepatitis B virus, hepatitis C virus, cytomegalovirus, a West Nile virus-like infection, allergic reactions and febrile non-haemolytic transfusion reactions achieved using plasma treated with methylene blue and visible light (MBP) and quarantine plasma (QP) was constructed for Spain. QP costs were estimated using data from one blood centre in Spain and published literature. The costs of producing fresh-frozen plasma from whole blood, apheresis plasma, and multicomponent apheresis, and separately for passive and active methods of donor recall for QP were included. Costs and outcomes over a 5-year and lifetime time horizon were estimated.
  
  
  
  Compared to passive QP, MBP led to a net increase of € 850,352, and compared to active QP, MBP led to a net saving of € 5,890,425 over a 5-year period. Compared to passive QP, MBP increased the cost of fresh-frozen plasma per patient by € 7.21 and had an incremental cost-utility ratio of € 705,126 per quality-adjusted life-year. Compared to active QP, MBP reduced cost by € 50.46 per patient and was more effective.
  
  
  
  Plasma collection method and quarantine approach had the strongest influence on the budget impact and cost-utility of MBP. If QP relies on plasma from whole blood collection and passive quarantine, it is less costly than MBP. However, MPB was estimated to be more effective than QP in all analyses.
authors.affiliation: Global Medicines Program, Department of Global Health, University of Washington, Seattle, United States of America.|Pharmaceutical Outcomes Research and Policy Program, Department of Pharmacy, University of Washington, Seattle, United States of America.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Babigumira
authors.affiliation: Global Medicines Program, Department of Global Health, University of Washington, Seattle, United States of America.|Pharmaceutical Outcomes Research and Policy Program, Department of Pharmacy, University of Washington, Seattle, United States of America.
authors.forename: Solomon J
authors.initials: SJ
authors.lastname: Lubinga
authors.affiliation: Community Blood Transfusion Centre, Valencia, Spain.
authors.forename: Emma
authors.initials: E
authors.lastname: Castro
authors.affiliation: Blood Systems Research Institute, San Francisco, United States of America.|Department of Laboratory Medicine, UCSF, San Francisco, United States of America.
authors.forename: Brian
authors.initials: B
authors.lastname: Custer
mesh_terms: D003365:Costs and Cost Analysis; D004203:Disinfection / Q000191:economics* / Q000379:methods*; D006801:Humans; D008751:Methylene Blue / Q000494:pharmacology*; D050296:Microbial Viability / Q000187:drug effects; D010949:Plasma / Q000821:virology*
chemical_list: D008751:Methylene Blue