Pharmaco-economics of blood transfusion safety: review of the available evidence

Background and Objectives Pharmaco-economics provides a standardized methodology for valid comparisons of interventions in different fields of health care. The role of pharmaco-economics in the safety of blood and blood products has, however, been very limited to date. This review discusses the pharmaco-economic evaluations of strategies to enhance blood product safety that have been published in the scientific literature. Materials and Methods We reviewed pharmaco-economic methodology with special reference to cost-effectiveness analysis. We searched the literature for cost-effectiveness in blood product safety. Results Net costs per quality adjusted life-year (QALY) gained varied from cost-saving for human immunodefiency virus (HIV)- and hepatitis C virus (HCV) antibody screening and leucoreduction to several million $US per QALY gained for solvent-detergent treatment of plasma, nucleic acid amplification testing and HIV p24 antigen testing. Conclusions To date the safety of blood transfusion has been largely determined by available technology, irrespective of pharmaco-economics. Net costs up to several million $US per QALY gained were found for interventions implemented