The cost-effectiveness of pathogen reduction technology as assessed using a multiple risk reduction model

BACKGROUND: Pathogen reduction technology (PRT) for labile blood components has the potential to reduce the risk of many adverse events associated with transfusion. Because of the potential broad-spectrum risk reduction capability of PRT, the health economics of PRT could be an important consideration in decision making for this technology STUDY DESIGN AND METHODS: Decision analytic models comparing current blood safety screens and interventions to riboflavin-based whole blood PRT (currently in development) and separately to platelets (PLTs)-and-plasma PAT from the health care system perspective in Canada were used to assess the cost-utility of PAT in reducing the following adverse events: human immunodeficiency virus, hepatitis B virus, hepatitis C virus, human T-lymphotropic virus, syphilis, West Nile virus, bacteria, Chikungunya virus, cytomegalovirus, Trypanosoma cruzi, graft-versus-host disease, febrile nonhemolytic transfusion reactions, and transfusion-related immunomodulation PAT was modeled as an addition to rather than a replacement for current interventions. The potential of PAT to reduce the risk of an unknown pathogen was not assessed. RESULTS: Whole blood PAT was estimated to have a cost-effectiveness of $1,276,000/quality-adjusted life-year (QALY; 95% confidence interval [Cl] approximation, 600,000-3,313,000) compared to current screens and interventions. PLTs-and-plasma PAT was estimated to have a cost-effectiveness of $1,423,000/QALY (95% Cl approximation, 834,000-2,818,000) on an all-transfusions basis. CONCLUSIONS: Because of the complexity of transfusion risks and practices, the cost-effectiveness of whole blood or PLTs-and-plasma PAT can be modeled provided that assumptions and simplifications are made. Uncertainty remains with respect to the risk reduction that can be achieved for some adverse events. Nevertheless, the results of this cost-effectiveness analysis can be used to inform policy decisions regarding PRT-technology in the context of other initiatives designed to improve transfusion safety