Cost-effectiveness of hepatitis C screening of blood donations

Sandrine Loubiere1, Jean-Paul Moatti

  • 1French National Institute of Medical Research, INSERM U379, 23 rue Stanislas Torrents, 13006 Marseilles, France. loubiere@marseille.inserm.fr

Some screening programs have very high costs per life-year saved and require large financial support. Public policies decision-makers need criteria to appreciate the costs and benefices of such programs. The safety of blood transfusions is a specific example of such a situation, in which the decision to reduce residual risks could be a highly debatable use of resources when the additional effectiveness is small. This article analyzes various economic evaluations of hepatitis C virus screening strategies and discusses the results. The screening of blood donations for hepatitis C virus antibodies is cost-effective and enzyme-linked immunoblot assay testing appears to be the most efficient and reliable test for daily processing of a large number of samples in a large blood bank. In contrast, new tests proposed to increase safety in blood donations, such as the adjunction of polymerase chain reaction testing, do not compare favorably with socially-acceptable threshold in health economics.