Cost-effectiveness of nucleic acid test screening of volunteer blood donations for hepatitis B, hepatitis C and human immunodeficiency virus in the United States
Article first published online: 30 JAN 2004
Volume 86, Issue 1, pages 28–40, January 2004
How to Cite
Marshall, D. A., Kleinman, S. H., Wong, J. B., AuBuchon, J. P., Grima, D. T., Kulin, N. A. and Weinstein, M. C. (2004), Cost-effectiveness of nucleic acid test screening of volunteer blood donations for hepatitis B, hepatitis C and human immunodeficiency virus in the United States. Vox Sanguinis, 86: 28–40. doi: 10.1111/j.0042-9007.2004.00379.x
- Issue published online: 30 JAN 2004
- Article first published online: 30 JAN 2004
- Received: 16 April 2003, revised 26 August 2003, accepted 15 October 2003
- blood screening;
- cost-effectiveness analysis;
- decision analysis model;
- hepatitis B;
- hepatitis C;
- human immunodeficiency virus
Background and Objectives The aim of this study was to examine the cost-effectiveness of adding nucleic acid testing (NAT) to serological (antibody and antigen) screening protocols for donated blood in the United States (US) with the purpose of reducing the risks of transfusion-transmission of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV).
Materials and Methods The costs, health consequences and cost-effectiveness of adding either minipool or individual-donor NAT to serological screening (SS) testing were estimated using a decision-analysis model.
Results With the given modelling assumptions, adding minipool NAT would avoid an estimated 37, 128 and eight cases of HBV, HCV and HIV, respectively, and save ≈ 53 additional years of life and 102 additional quality adjusted life years (QALYs) compared with SS, at a net cost of $154 million. SS + minipool NAT − p24 compared with SS alone resulted in an incremental cost-effectiveness ratio of $1·5 million per QALY gained (range in sensitivity analysis $1·0–2·1 million per QALY gained) in this US analysis.
Conclusions The cost effectiveness of adding NAT screening is outside the typical range for most healthcare interventions, but not for established blood safety measures.