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Addressing the risk of bacterial contamination in platelets: a hospital economic perspective
Justin W Li1, Mark E Brecher2,3, Jessica L Jacobson4
1Dobson DaVanzo & Associates, LLC, Vienna, Virginia.
Insights
Pathogen reduction technology (PRT) treated platelets cost hospitals significantly more than secondary tested platelets. Implementing pathogen reduction technology (PRT) for platelets increases costs due to higher prices and reduced effectiveness.
Area of Science:
- Transfusion Medicine
- Health Economics
- Blood Safety
Background:
- Bacterial contamination of platelets (PLTs) poses a significant risk.
- Regulatory bodies recommend secondary testing or pathogen reduction technology (PRT) for PLTs.
- The economic impact of these blood safety measures is not fully understood.
Purpose of the Study:
- To model and compare the incurred costs of using PRT-treated PLTs versus secondary tested PLTs in hospitals.
- To evaluate the cost implications of INTERCEPT PRT versus the PLT PGD Test.
Main Methods:
- Cost-effectiveness modeling was used to compare two blood safety strategies.
- The model analyzed costs associated with acquisition, processing, and transfusion of PLTs.
- Specific cost components including purchase price, therapeutic effectiveness, and outdating were assessed.
Main Results:
- PRT-treated apheresis PLTs cost $221.27 more per unit than PGD-tested PLTs.
- Increased costs are attributed to higher purchase price, lower therapeutic effectiveness, and reduced storage days leading to outdating.
- Avoided costs from secondary testing and irradiation were minimal compared to incremental expenses.
Conclusions:
- PRT-treated PLTs are significantly more expensive than PGD-tested PLTs.
- Extending PLT shelf life with PGD testing offers substantial savings, likely exceeding implementation costs.
- Findings can guide hospital decisions on selecting optimal blood safety strategies.
Background:
Bacterially contaminated platelets (PLTs) remain a serious risk. The Food and Drug Administration has issued draft guidance recommending hospitals implement secondary testing or transfuse PLTs that have been treated with pathogen reduction technology (PRT). The cost implications of these approaches are not well understood.
Study Design And Methods:
We modeled incurred costs when hospitals acquire, process, and transfuse PLTs that are PRT treated with INTERCEPT (Cerus Corp.) or secondary tested with the PLT PGD Test (Verax Biomedical).
Results:
Hospitals will spend $221.27 (30.0%) more per PRT-treated apheresis PLT unit administered compared to a Zika-tested apheresis PLT unit that is irradiated and PGD tested in hospital. This difference is reflected in PRT PLT units having: 1) a higher hospital purchase price ($100.00 additional charge compared to an untreated PLT); 2) lower therapeutic effectiveness than untreated PLTs among hematologic-oncologic patients, which contributes to additional transfusions ($96.05); or 3) fewer PLT storage days, which contributes to higher outdating cost from expired PLTs ($67.87). Only a small portion of the incremental costs for PRT-treated PLTs are offset by costs that may be avoided, including primary bacterial culture, secondary bacterial testing ($26.65), hospital irradiation ($8.50), Zika testing ($4.47), and other costs ($3.03).
Conclusion:
The significantly higher cost of PRT-treated PLTs over PGD-tested PLTs should interest stakeholders. For hospitals that outdate PLTs, savings associated with expiration extension to 7 days by adding PGD testing will likely be substantially greater than the cost of implementing PGD-testing. Our findings might usefully inform a hospital's decision to select a particular blood safety approach.
