溶剤と洗剤で処理されたプラズマの安全性と費用対効果. リスクゼロの血液供給を探しています
1Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756.
JAMA
|October 19, 1994
まとめ
溶媒洗浄剤処理冷凍プラズマ (SD FP) は,高いコストで獲得された最小限の品質調整寿命を提供します. 公衆衛生上の利益は,コストと潜在的な非包膜ウイルスの感染リスクのために,広範な使用を正当化しません.
科学分野:
- 輸血医学とは
- 公共衛生経済学 公共衛生経済学
- 感染症予防 感染症予防
背景:
- 溶媒洗浄剤で処理された冷凍プラズマ (SD FP) は,脂質に包まれたウイルスの感染リスクを軽減します.
- この処理方法にはコストがかかり,プラズマの集積により,封じられていないウイルスの感染リスクが増加する可能性があります.
研究 の 目的:
- SDFPの使用による公衆衛生と経済への影響を評価する.
- SDFPの費用対効果を未処理プラズマと比較して評価する.
主な方法:
- 改変されたマルコフ決定分析モデルを使用して,輸血の結果を評価しました.
- データは,高等保健センターと医学文献から得られたものです.
- 費用対効果は,品質調整寿命年あたりのコスト (QALY) 節約として測定されました.
主要な成果:
- SD FPは,単位あたり約19ドルで,小さな純利益 (35分QALY) を提供しています.
- 全国的に,SDFPは年間425万ドルで147QALYを節約できます.
- 限界的費用対効果は,治療費用と臨床環境に敏感なQALY1回あたり289,300ドルでした.
結論:
- SDFPの高いコストと限られたメリットは,その広範な実施をサポートしません.
- 包装されていないウイルスの感染のリスクは,SD FPの利点を否定することができます.
- 現在の証拠は,SDFPは正当な公衆衛生戦略ではないことを示唆しています.
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