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Related Experiment Videos

Mortality risks, costs, and decision making in transfusion medicine.

N Blumberg1, J M Heal

  • 1Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Box 608, 601 Elmwood Ave, Rochester, NY 14642, USA.

American Journal of Clinical Pathology
|May 8, 2001
PubMed
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Analyzing transfusion costs by deaths averted reveals leukocyte-reduced transfusions and HIV-1 antibody testing are highly cost-efficient for saving lives. Apheresis platelets and solvent detergent plasma are less cost-effective for mortality reduction.

Area of Science:

  • Health Economics
  • Transfusion Medicine
  • Public Health

Background:

  • Traditional cost-effectiveness analyses like quality-adjusted life year (QALY) can be complex.
  • Assigning monetary values to severe outcomes like death is often arbitrary.
  • An alternative approach focusing on costs to avert fatal outcomes may aid resource allocation in transfusion medicine.

Purpose of the Study:

  • To evaluate the cost-effectiveness of transfusion medicine technologies based on the cost per death averted.
  • To compare the cost per death avoided for apheresis platelets, solvent detergent-treated plasma, and leukocyte-reduced transfusions against donor viral testing.
  • To inform resource allocation decisions for transfusion services.

Main Methods:

  • Calculated the incremental cost per death avoided for specific transfusion interventions and donor viral testing.

Related Experiment Videos

  • Interventions analyzed included apheresis platelets vs. random platelets, solvent detergent plasma vs. untreated plasma, and leukocyte-reduced vs. unmodified transfusions in cardiac surgery.
  • Data were compared with current donor viral testing (HIV-1 antibody and antigen testing).

    • Main Results:

    • Leukocyte-reduced transfusions in cardiac surgery cost $11,000 per death avoided, averting 14 deaths annually.
    • HIV-1 antibody testing cost $22,000 per death avoided, averting 6.0 deaths annually.
    • Single-donor apheresis platelets ($15 million/death averted) and solvent detergent plasma ($17 million/death averted) were significantly more expensive with fewer deaths averted.

    Conclusions:

    • HIV-1 antibody testing and leukocyte-reduced transfusions in cardiac surgery represent comparably cost-efficient methods for reducing transfusion-related mortality.
    • Solvent detergent plasma and apheresis platelets are less cost-effective strategies for mortality reduction in transfusion medicine.
    • Cost-effectiveness analysis focused on averting deaths provides a valuable adjunct to QALY analysis for resource allocation.