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[Efficiency of hepatitis C virus screening before and after blood transfusion]
V Josset1, P Chamouni, M P Tavolacci
1Département d'épidémiologie et de santé publique, Unité d'information médicale, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France. valerie.josset@chu-rouen.fr
Insights
Evaluating hepatitis C screening strategies for blood transfusions shows that testing before transfusion only is the most cost-efficient. This approach balances efficacy and cost, making it a preferred method for viral hepatitis C screening.
Area of Science:
- Transfusion Medicine
- Infectious Disease Epidemiology
- Health Economics
Background:
- Viral hepatitis C (HCV) poses a risk in blood transfusions.
- Evaluating different screening strategies is crucial for patient safety and resource allocation.
Purpose of the Study:
- To compare the efficiency and cost-effectiveness of four distinct HCV screening strategies for transfused patients.
- To identify the optimal screening approach for minimizing costs per positive test.
Main Methods:
- Decision analysis was employed to virtually apply four screening strategies to transfused patients.
- Strategies included no screening, testing before and after (3 or 6 months), and testing before only.
- Efficacy, efficiency (cost per positive test), and marginal costs were assessed.
Main Results:
- The efficacy of testing before transfusion only was comparable to strategies involving post-transfusion testing.
- Testing before transfusion only yielded the lowest marginal cost per positive test ($343).
- Strategies including post-transfusion testing significantly increased marginal costs ($559-$619) and overall costs ($5824).
Conclusions:
- Systematic screening for hepatitis C before blood transfusion is the most efficient strategy.
- This approach offers a favorable balance between identifying infections and managing healthcare costs.
Unlabelled:
Efficiency of a viral hepatitis C screening strategy before and after blood transfusion has to be evaluated.
Methods:
Four screening strategies were virtually applied to the population of transfused patients at Rouen University Hospital during 1996 and then compared : the first without any systematic HCV screening test; the second with systematic testing both before and 3 months after transfusion; the third with systematic testing both before and 6 months after transfusion ; the last defined as systematic testing before transfusion only. The efficacy (i.e. number of positive tests), the efficiency (i.e. average cost per positive test) and the marginal costs of moving from a strategy to another one were assessed using decision analysis.
Results:
The efficacy of systematic screening test before transfusion only (361 per positive test), systematic testing both before and three months after (523 per positive test) or six months after (488 per positive test) transfusion was similar, but the efficacy of the strategy without any systematic screening test (385 per positive test) was lower. The systematization of screening test both before, and three months, or 6 months after transfusion lead to a marginal cost of 619 , and 559 per positive test respectively. The systematization of testing before transfusion only lead to a marginal cost of 343 per positive test. Adding systematic testing after transfusion lead to a marginal cost of 5824 per positive test.
Conclusion:
Systematic screening tests before transfusion only can be considered as the most efficient strategy.
