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|Title:||Cost Effectiveness of Three Scenarios for Blood Screening||Authors:||Tellez, D.
CASTRO SANCHEZ, Amparo
|Issue Date:||2012||Publisher:||WILEY-BLACKWELL||Source:||TRANSFUSION, 52 (Special Issue, Supplement 3), p. 221A-221A||Abstract:||Background/Case studies: Nucleic Acid Testing is a sensitive method for virus detection in the antibody-negative window period that reduces the risk of infection by blood transfusion.NAT has shown to reduce the WP, approximately in 42% for HBV (from 59 to 34 days), in 50% for HIV (from 22 to 11 days) and for HCV from 70 to 10 days. In the past years NAT has been used for screening of HBV, HCV and HIV in Colombian blood banks but to date the Ministry of Health has not issued a formal requirement for this testing. The aim is to develop an economic study that allows to compare three scenaries for screening of HBV, HCV and HIV applied to blood donors in Colombia. Study Design/Methods: This is a cost-effectiveness study which used a model of Markov with three diseases involved. It was structured with 10 health states and 19 primary events. The temporal horizon used was 30 years with cycles of 1 year. The discount rate used was 5% for costs and events. Three strategies were compared. The outputs of the model included life years gained, avoided infections, accumulated costs and costs per life year gained. The target population was analysed for patients 42 years old (both genders) who received blood transfusion for any reason. A cohort of 100.000 patients was used in the model through the use of deterministic analysis and a probabilistic simulation. Results were later used for a sensitivity analysis in an univariate and multivariate level. Results/Findings:The number of units calculated per patient was of 3.2 units. The improved scenario for screening which included HBsAg, Anti HBCAg, HCV Ag, Anti HCVAg, HIV Combo showed an Incremental Cost Effectiveness Ratio (ICER) of $23,622 USD per life year gained. The improved scenario plus NAT showed an ICER of $97,210 USD per life year gained. The two latter strategies behaved as dominant scenarios. The sensitivity analysis showed that the most important variables in the determination of the ICER were the cost of NAT and the probability of false-negative with NAT. In the probabilistic simulation the use of NAT was closer to the threshold of cost effectiveness. Conclusion: Cost effectiveness analysis allow to make a valuable use of resources particularly in countries where costs restriction is the rule. Also they allow to take decisions in health systems in a perspective that is useful for every stakeholder. The ICER was found to be positive for the improved scenario which introduced the use of HCVAg for screening of all blood donations. Variables with the highest infl uence on cost effectiveness were the rate of negative falses for NAT and the cost of the test itself.||Notes:||[Tellez, D.] Abbott Diagnost, Bogota, Colombia. [Leisewitz, T.; Castro, A.] HEORT, Bogota, Colombia. [Penuela, O.] Fdn Abood Shaio, Blood Bank, Bogota, Colombia. [Castro, A.] Univ Hasselt, Interuniv Inst Biostat & Stat Bioinformat, CenStat, Brussels, Belgium. [Leisewitz, T.] Pontificia Univ Catolica Chile, Hlth Econ Outcomes Res Team, Santiago, Chile.||Keywords:||Hematology||Document URI:||http://hdl.handle.net/1942/14235||ISSN:||0041-1132||e-ISSN:||1537-2995||ISI #:||000308398600546||Category:||M||Type:||Journal Contribution|
|Appears in Collections:||Research publications|
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