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Cost-Effectiveness of Testing for Human Immunodeficiency Virus And Hepatitis C Virus Among Blood Transfusion Recipients

Published online by Cambridge University Press:  02 January 2015

Simone Mathoulin-Pelissier ,
Louis-Rachid Salmi ,
Pierre Fialon  and
Roger Salamon
Simone Mathoulin-Pelissier*
Affiliation:
Institute of Public Health, Epidemiology, and Development, Bordeaux University Hospital, Bordeaux, France
Louis-Rachid Salmi
Affiliation:
Institute of Public Health, Epidemiology, and Development, Bordeaux University Hospital, Bordeaux, France
Pierre Fialon
Affiliation:
Bordeaux University Hospital, Bordeaux, France
Roger Salamon
Affiliation:
Institute of Public Health, Epidemiology, and Development, Bordeaux University Hospital, Bordeaux, France
*
Institut Bergonié, 229 Cours de l'Argonne, 33076 Bordeaux cedex, France
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Abstract

Objective:

To choose the most cost-effective option for detecting human immunodeficiency virus (HIV-1) and hepatitis C virus (HCV) among blood transfusion recipients.

Design:

Cost-effectiveness analysis. Effectiveness was expressed as the number of HIV-1 or HCV infections detected, regardless of whether they were related to transfusion. To estimate costs, we assumed hospital insurance would cover costs related to detection and compensation, when granted.

Setting:

A 2,890-bed acute care teaching hospital in Bordeaux, France.

Methods:

Eight options were defined, from the simplest, which would be to do nothing, to a maximal approach, which would be to keep a serum sample in a serum library for a lookback and perform tests for antibody to HIV-1 and to HCV before and 3 months after transfusion. Data on probabilities and costs were taken from the literature and experiences of French hospitals.

Results:

The most cost-effective option was to perform viral antibody testing before transfusions (option 3), which would detect 27 infections per 1,000 patients, for an expenditure of US $1,260 per detected patient Option 6, obtaining a serum sample before transfusion and performing tests for antibody to HIV-1 and to HCV 3 months after transfusion, had a similar cost-effectiveness ratio but detected only 16 infections per 1,000 patients. Performing tests before and 3 months after transfusion (option 4), compared with option 3, would detect 1 additional infection for an additional cost of US $8,322.

Conclusion:

The most cost-effective options are not specific to blood transfusion recipients and might be more suited to all hospitalized patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 2 , February 2003 , pp. 132 - 136
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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References

1.Aubuchon, JP, Birkmeyer, JD, Busch, ME. Cost-effectiveness of expanded human immunodeficiency virus-testing protocols for donated blood. Transfusion 1997;37:45–51.Google Scholar
2.Aubuchon, JP, Birkmeyer, JD, Busch, MP. Safety of the blood supply in the United States: opportunities and controversies. Ann Intern Med 1997;127:904–909.CrossRefGoogle ScholarPubMed
3.Aubuchon, JP, Kruskall, MS. Transfusion safety: realigning effort with risks. Transfusion 1997;37:1211–1216.CrossRefGoogle ScholarPubMed
4.Pereira, A. Health and economic consequences of HCV lookback. Transfusion 2001;41:832–839.CrossRefGoogle ScholarPubMed
5.Morel, P, Hervé, P. Surveillance of blood transfusion safety: contribution of the hemovigilance strategy in France. Transfus Med Rev 1998;12:109–127.Google Scholar
6.Direction Générale de la Santé. Circulaire DGS/DH n°96«09 du 1er octobre 1996 relative aux analyses et tests pratiqués sur des receveurs de produits sanguins labiles. Bulletin Officiel de la République Française 1996;123–128.Google Scholar
7.Mushlin, AI, Ruchlin, HS, Callahan, MA. Cost-effectiveness of diagnostics test. Lancet 2001;358:1353–1355.Google Scholar
8.Aubuchon, JP. The role of decision analysis in transfusion medicine. Vox Sang 1996;71:1–5.Google Scholar
9.Drummond, ME. Allocating resources. Int J Technol Assess Health Care 1990;6:77–92.Google Scholar
10.Whyte, G. Risk management in blood transfusion services. Vox Sang 1998;74:105–109.Google Scholar
11.Detsky, AS, Naglie, G, Khran, M, Redelmeier, DA, Naimark, D. Primer on medical decision analysis: II. Building a tree. Med Decis Making 1997;17:126–135.CrossRefGoogle Scholar
12.Khran, M, Naglie, G, Naimark, D, Redelmeier, DA, Detsky, AS. Primer on medical decision analysis: IV. Analyzing the model and interpreting the results. Med Decis Making 1997;17:142–151.Google Scholar
13.Naglie, G, Khran, M, Naimark, D, Redelmeier, DA. Detsky, AS. Primer on medical decision analysis: III. Estimating probabilities and utilities. Med Decis Making 1997;17:136–141.Google Scholar
14.Siegel, JE, Weinstein, MC, Russel, LB, Gold, MR, for the panel on Cost-Effectiveness in Health Medicine. Recommendations for reporting cost-effectiveness analyses. JAMA 1996;276:1339–1341.Google Scholar
15.Vicariot, M, Marion, V, Murati, M. Suivi de 2100 malades transfusés au CHU de Brest. Gazette de la Transfusion 1994;104:5–9.Google Scholar
16.Vamvakas, EC, Taswell, HE. Mortality after blood transfusion. Transfus Med Rev 1994;8:267–280.Google Scholar
17.Mathoulin-Pélissier, S, Vicariot, M, Gross, S, et al. Étude pilote des caractéristiques des patients transfusés et des produits sanguins labiles utilisés. Transfus Clin Biol 1997;4:533–540.CrossRefGoogle Scholar
18.Mathoulin-Pélissier, S, Vicariot, M, Courtois, F, et al. Faisabilité d'un suivi de patients transfusés. Transfus Clin Biol 1998;5:266–274.Google Scholar
19.Laperche, S, pour le groupe de travail des Hépatites virales et Retrovirus. Réflexions concernant le dépistage des acides nucléiques des virus des hépatites B et C et du virus de l'immunodéficience humaine dans la qualification biologique des dons. Transfus Clin Biol 1998;5:139–146.Google Scholar
20.Agence française du sang. La rénovation du service public transfusionnel: les assurances en transfusion. In: Rapport sur l'activité de transfusion sanguine (juillet 1995-juillet 1996). Paris: La documentation française; 1997:100–103.Google Scholar
21.Morrison, AS. Screening. In: Rothman, KJ, Greenland, S, eds. Modern Epidemiology, 2nd ed. Philadelphia: Lippincott-Raven; 1998:499–518.Google Scholar
22.Salmi, LR, Mathoulin, S, Perez, P, Lawson-Ayayi, S. Dépistage et détection précoce en transfusion sanguine: quand sont-ils indiqués? Transfus Clin Biol 1997;4:417–427.Google Scholar
23.Regan, FA, Hewitt, P, Barbara, JA, Contreras, M. Prospective investigation of transfusion transmitted infection in recipients of over 20,000 units of blood. BMJ 2000;320:403–406.Google Scholar