Nadine Shehata1, Michele Kohli, Allan Detsky. 1. Department of Health Management, Policy and Evaluation, University of Toronto, Ontario, Canada. nadine.shehata@bloodservices.ca
Abstract
BACKGROUND: The cost-effectiveness of four blood donor screening strategies for malaria was estimated to determine whether transmission by transfusion can be reduced. STUDY DESIGN AND METHODS: A decision analysis model was developed to compare 1) not screening allogeneic blood donors for malaria (Strategy 1); 2) using the standard questionnaire (Strategy 2); 3) using the standard questionnaire followed by testing blood donors with risk factors for malaria with PCR (Strategy 3); and 4) screening all blood donors using PCR (Strategy 4). The expected costs and the number of cases of malaria for each strategy were compared and incremental cost-effectiveness ratios were calculated as the cost per case of malaria averted. All costs are in Canadian dollars. RESULTS: Strategies 2 and 3 had the same effectiveness but different costs, with Strategy 3 being less costly. Compared to Strategy 1, the incremental cost effectiveness ratio was 6463 dollars per case of malaria averted for Strategy 3. Strategy 4 resulted in less transmission of malaria (0.4/million donors), but the cost compared to Strategy 3 was 3,972,624 dollars per case of malaria averted. CONCLUSION: The addition of PCR to the standard screening questionnaire is economically attractive compared to the current standard screening questionnaire.
BACKGROUND: The cost-effectiveness of four blood donor screening strategies for malaria was estimated to determine whether transmission by transfusion can be reduced. STUDY DESIGN AND METHODS: A decision analysis model was developed to compare 1) not screening allogeneic blood donors for malaria (Strategy 1); 2) using the standard questionnaire (Strategy 2); 3) using the standard questionnaire followed by testing blood donors with risk factors for malaria with PCR (Strategy 3); and 4) screening all blood donors using PCR (Strategy 4). The expected costs and the number of cases of malaria for each strategy were compared and incremental cost-effectiveness ratios were calculated as the cost per case of malaria averted. All costs are in Canadian dollars. RESULTS: Strategies 2 and 3 had the same effectiveness but different costs, with Strategy 3 being less costly. Compared to Strategy 1, the incremental cost effectiveness ratio was 6463 dollars per case of malaria averted for Strategy 3. Strategy 4 resulted in less transmission of malaria (0.4/million donors), but the cost compared to Strategy 3 was 3,972,624 dollars per case of malaria averted. CONCLUSION: The addition of PCR to the standard screening questionnaire is economically attractive compared to the current standard screening questionnaire.
Authors: Katherine D Ellingson; Mathew R P Sapiano; Kathryn A Haass; Alexandra A Savinkina; Misha L Baker; Richard A Henry; James J Berger; Matthew J Kuehnert; Sridhar V Basavaraju Journal: Transfusion Date: 2017-06 Impact factor: 3.157
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