Cost-effectiveness of nucleic acid test screening of volunteer blood donations for hepatitis B, hepatitis C and human immunodeficiency virus in the United States

Background and Objectives The aim of this study was to examine the cost‐effectiveness of adding nucleic acid testing (NAT) to serological (antibody and antigen) screening protocols for donated blood in the United States (US) with the purpose of reducing the risks of transfusion‐transmission of hepa...

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Veröffentlicht in:	Vox sanguinis 2004-01, Vol.86 (1), p.28-40
Hauptverfasser:	Marshall, D. A., Kleinman, S. H., Wong, J. B., AuBuchon, J. P., Grima, D. T., Kulin, N. A., Weinstein, M. C.
Format:	Artikel
Sprache:	eng
Schlagworte:	Blood Donors blood screening Cost-Benefit Analysis cost-effectiveness analysis decision analysis model hepatitis B Hepatitis B - diagnosis Hepatitis B - economics Hepatitis B - transmission hepatitis C Hepatitis C - diagnosis Hepatitis C - economics Hepatitis C - transmission HIV Infections - diagnosis HIV Infections - economics HIV Infections - transmission human immunodeficiency virus Humans Mass Screening - economics Mass Screening - methods Models, Economic Nucleic Acid Amplification Techniques - economics United States Virus Diseases - diagnosis Virus Diseases - economics Virus Diseases - transmission
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container_title	Vox sanguinis
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creator	Marshall, D. A. Kleinman, S. H. Wong, J. B. AuBuchon, J. P. Grima, D. T. Kulin, N. A. Weinstein, M. C.
description	Background and Objectives The aim of this study was to examine the cost‐effectiveness of adding nucleic acid testing (NAT) to serological (antibody and antigen) screening protocols for donated blood in the United States (US) with the purpose of reducing the risks of transfusion‐transmission of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Materials and Methods The costs, health consequences and cost‐effectiveness of adding either minipool or individual‐donor NAT to serological screening (SS) testing were estimated using a decision‐analysis model. Results With the given modelling assumptions, adding minipool NAT would avoid an estimated 37, 128 and eight cases of HBV, HCV and HIV, respectively, and save ≈ 53 additional years of life and 102 additional quality adjusted life years (QALYs) compared with SS, at a net cost of $154 million. SS + minipool NAT − p24 compared with SS alone resulted in an incremental cost‐effectiveness ratio of $1·5 million per QALY gained (range in sensitivity analysis $1·0–2·1 million per QALY gained) in this US analysis. Conclusions The cost effectiveness of adding NAT screening is outside the typical range for most healthcare interventions, but not for established blood safety measures.
doi_str_mv	10.1111/j.0042-9007.2004.00379.x
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A. ; Kleinman, S. H. ; Wong, J. B. ; AuBuchon, J. P. ; Grima, D. T. ; Kulin, N. A. ; Weinstein, M. C.</creator><creatorcontrib>Marshall, D. A. ; Kleinman, S. H. ; Wong, J. B. ; AuBuchon, J. P. ; Grima, D. T. ; Kulin, N. A. ; Weinstein, M. C.</creatorcontrib><description>Background and Objectives The aim of this study was to examine the cost‐effectiveness of adding nucleic acid testing (NAT) to serological (antibody and antigen) screening protocols for donated blood in the United States (US) with the purpose of reducing the risks of transfusion‐transmission of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Materials and Methods The costs, health consequences and cost‐effectiveness of adding either minipool or individual‐donor NAT to serological screening (SS) testing were estimated using a decision‐analysis model. Results With the given modelling assumptions, adding minipool NAT would avoid an estimated 37, 128 and eight cases of HBV, HCV and HIV, respectively, and save ≈ 53 additional years of life and 102 additional quality adjusted life years (QALYs) compared with SS, at a net cost of $154 million. SS + minipool NAT − p24 compared with SS alone resulted in an incremental cost‐effectiveness ratio of $1·5 million per QALY gained (range in sensitivity analysis $1·0–2·1 million per QALY gained) in this US analysis. Conclusions The cost effectiveness of adding NAT screening is outside the typical range for most healthcare interventions, but not for established blood safety measures.</description><identifier>ISSN: 0042-9007</identifier><identifier>EISSN: 1423-0410</identifier><identifier>DOI: 10.1111/j.0042-9007.2004.00379.x</identifier><identifier>PMID: 14984557</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Blood Donors ; blood screening ; Cost-Benefit Analysis ; cost-effectiveness analysis ; decision analysis model ; hepatitis B ; Hepatitis B - diagnosis ; Hepatitis B - economics ; Hepatitis B - transmission ; hepatitis C ; Hepatitis C - diagnosis ; Hepatitis C - economics ; Hepatitis C - transmission ; HIV Infections - diagnosis ; HIV Infections - economics ; HIV Infections - transmission ; human immunodeficiency virus ; Humans ; Mass Screening - economics ; Mass Screening - methods ; Models, Economic ; Nucleic Acid Amplification Techniques - economics ; United States ; Virus Diseases - diagnosis ; Virus Diseases - economics ; Virus Diseases - transmission</subject><ispartof>Vox sanguinis, 2004-01, Vol.86 (1), p.28-40</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4029-90590f113eeff5b3c80d128d910cb85d7ebc3658f26a4f9441ad7397062337523</citedby><cites>FETCH-LOGICAL-c4029-90590f113eeff5b3c80d128d910cb85d7ebc3658f26a4f9441ad7397062337523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.0042-9007.2004.00379.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.0042-9007.2004.00379.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14984557$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marshall, D. A.</creatorcontrib><creatorcontrib>Kleinman, S. H.</creatorcontrib><creatorcontrib>Wong, J. B.</creatorcontrib><creatorcontrib>AuBuchon, J. P.</creatorcontrib><creatorcontrib>Grima, D. T.</creatorcontrib><creatorcontrib>Kulin, N. A.</creatorcontrib><creatorcontrib>Weinstein, M. C.</creatorcontrib><title>Cost-effectiveness of nucleic acid test screening of volunteer blood donations for hepatitis B, hepatitis C and human immunodeficiency virus in the United States</title><title>Vox sanguinis</title><addtitle>Vox Sang</addtitle><description>Background and Objectives The aim of this study was to examine the cost‐effectiveness of adding nucleic acid testing (NAT) to serological (antibody and antigen) screening protocols for donated blood in the United States (US) with the purpose of reducing the risks of transfusion‐transmission of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Materials and Methods The costs, health consequences and cost‐effectiveness of adding either minipool or individual‐donor NAT to serological screening (SS) testing were estimated using a decision‐analysis model. Results With the given modelling assumptions, adding minipool NAT would avoid an estimated 37, 128 and eight cases of HBV, HCV and HIV, respectively, and save ≈ 53 additional years of life and 102 additional quality adjusted life years (QALYs) compared with SS, at a net cost of $154 million. SS + minipool NAT − p24 compared with SS alone resulted in an incremental cost‐effectiveness ratio of $1·5 million per QALY gained (range in sensitivity analysis $1·0–2·1 million per QALY gained) in this US analysis. Conclusions The cost effectiveness of adding NAT screening is outside the typical range for most healthcare interventions, but not for established blood safety measures.</description><subject>Blood Donors</subject><subject>blood screening</subject><subject>Cost-Benefit Analysis</subject><subject>cost-effectiveness analysis</subject><subject>decision analysis model</subject><subject>hepatitis B</subject><subject>Hepatitis B - diagnosis</subject><subject>Hepatitis B - economics</subject><subject>Hepatitis B - transmission</subject><subject>hepatitis C</subject><subject>Hepatitis C - diagnosis</subject><subject>Hepatitis C - economics</subject><subject>Hepatitis C - transmission</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - economics</subject><subject>HIV Infections - transmission</subject><subject>human immunodeficiency virus</subject><subject>Humans</subject><subject>Mass Screening - economics</subject><subject>Mass Screening - methods</subject><subject>Models, Economic</subject><subject>Nucleic Acid Amplification Techniques - economics</subject><subject>United States</subject><subject>Virus Diseases - diagnosis</subject><subject>Virus Diseases - economics</subject><subject>Virus Diseases - transmission</subject><issn>0042-9007</issn><issn>1423-0410</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUU1vEzEQtRCIhsJfQD5xYoO_9kviQiNoKyoq1Ba4WY49Sxx27dT2huTn8E_xkqhwxBfP07w3ozcPIUzJnOb3Zj0nRLCiJaSes1xmyOt2vnuEZlQwXhBByWM0eyCdoGcxrgkhDWvKp-iEirYRZVnP0K-Fj6mArgOd7BYcxIh9h92oe7AaK20NThATjjoAOOu-T-2t70eXAAJe9t4bbLxTyXoXcecDXsEmo2QjPnv9D1hg5QxejYNy2A7D6LyBzmoLTu_x1oYxYutwWgG-czaBwTdJ5dXP0ZNO9RFeHP9TdPfh_e3iori6Pr9cvLsqtCCszTbLlnSUcshmyiXXDTGUNaalRC-b0tSw1Lwqm45VSnStEFSZmrc1qRjndcn4KXp1mLsJ_n7MluVgo4a-Vw78GGVNq0ZUgmZicyDq4GMM0MlNsIMKe0mJnOKRazldXk6Xl1M88k88cpelL487xuUA5q_wmEcmvD0Qftoe9v89WH65_paLLC8OchsT7B7kKvyQVZ1dyq-fzuXZR1Z-vr1hsuK_AZ9dr5w</recordid><startdate>200401</startdate><enddate>200401</enddate><creator>Marshall, D. A.</creator><creator>Kleinman, S. H.</creator><creator>Wong, J. B.</creator><creator>AuBuchon, J. P.</creator><creator>Grima, D. T.</creator><creator>Kulin, N. A.</creator><creator>Weinstein, M. C.</creator><general>Blackwell Science Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200401</creationdate><title>Cost-effectiveness of nucleic acid test screening of volunteer blood donations for hepatitis B, hepatitis C and human immunodeficiency virus in the United States</title><author>Marshall, D. A. ; Kleinman, S. H. ; Wong, J. B. ; AuBuchon, J. P. ; Grima, D. T. ; Kulin, N. A. ; Weinstein, M. C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4029-90590f113eeff5b3c80d128d910cb85d7ebc3658f26a4f9441ad7397062337523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Blood Donors</topic><topic>blood screening</topic><topic>Cost-Benefit Analysis</topic><topic>cost-effectiveness analysis</topic><topic>decision analysis model</topic><topic>hepatitis B</topic><topic>Hepatitis B - diagnosis</topic><topic>Hepatitis B - economics</topic><topic>Hepatitis B - transmission</topic><topic>hepatitis C</topic><topic>Hepatitis C - diagnosis</topic><topic>Hepatitis C - economics</topic><topic>Hepatitis C - transmission</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - economics</topic><topic>HIV Infections - transmission</topic><topic>human immunodeficiency virus</topic><topic>Humans</topic><topic>Mass Screening - economics</topic><topic>Mass Screening - methods</topic><topic>Models, Economic</topic><topic>Nucleic Acid Amplification Techniques - economics</topic><topic>United States</topic><topic>Virus Diseases - diagnosis</topic><topic>Virus Diseases - economics</topic><topic>Virus Diseases - transmission</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marshall, D. A.</creatorcontrib><creatorcontrib>Kleinman, S. H.</creatorcontrib><creatorcontrib>Wong, J. B.</creatorcontrib><creatorcontrib>AuBuchon, J. P.</creatorcontrib><creatorcontrib>Grima, D. T.</creatorcontrib><creatorcontrib>Kulin, N. A.</creatorcontrib><creatorcontrib>Weinstein, M. C.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Vox sanguinis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marshall, D. A.</au><au>Kleinman, S. H.</au><au>Wong, J. B.</au><au>AuBuchon, J. P.</au><au>Grima, D. T.</au><au>Kulin, N. A.</au><au>Weinstein, M. C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-effectiveness of nucleic acid test screening of volunteer blood donations for hepatitis B, hepatitis C and human immunodeficiency virus in the United States</atitle><jtitle>Vox sanguinis</jtitle><addtitle>Vox Sang</addtitle><date>2004-01</date><risdate>2004</risdate><volume>86</volume><issue>1</issue><spage>28</spage><epage>40</epage><pages>28-40</pages><issn>0042-9007</issn><eissn>1423-0410</eissn><abstract>Background and Objectives The aim of this study was to examine the cost‐effectiveness of adding nucleic acid testing (NAT) to serological (antibody and antigen) screening protocols for donated blood in the United States (US) with the purpose of reducing the risks of transfusion‐transmission of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Materials and Methods The costs, health consequences and cost‐effectiveness of adding either minipool or individual‐donor NAT to serological screening (SS) testing were estimated using a decision‐analysis model. Results With the given modelling assumptions, adding minipool NAT would avoid an estimated 37, 128 and eight cases of HBV, HCV and HIV, respectively, and save ≈ 53 additional years of life and 102 additional quality adjusted life years (QALYs) compared with SS, at a net cost of $154 million. SS + minipool NAT − p24 compared with SS alone resulted in an incremental cost‐effectiveness ratio of $1·5 million per QALY gained (range in sensitivity analysis $1·0–2·1 million per QALY gained) in this US analysis. Conclusions The cost effectiveness of adding NAT screening is outside the typical range for most healthcare interventions, but not for established blood safety measures.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>14984557</pmid><doi>10.1111/j.0042-9007.2004.00379.x</doi><tpages>13</tpages></addata></record>
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subjects	Blood Donors blood screening Cost-Benefit Analysis cost-effectiveness analysis decision analysis model hepatitis B Hepatitis B - diagnosis Hepatitis B - economics Hepatitis B - transmission hepatitis C Hepatitis C - diagnosis Hepatitis C - economics Hepatitis C - transmission HIV Infections - diagnosis HIV Infections - economics HIV Infections - transmission human immunodeficiency virus Humans Mass Screening - economics Mass Screening - methods Models, Economic Nucleic Acid Amplification Techniques - economics United States Virus Diseases - diagnosis Virus Diseases - economics Virus Diseases - transmission
title	Cost-effectiveness of nucleic acid test screening of volunteer blood donations for hepatitis B, hepatitis C and human immunodeficiency virus in the United States
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