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Cost-effectiveness of screening the US blood supply for Trypanosoma cruzi

Agapova, Maria ; Busch, Michael P. ; Custer, Brian

Transfusion (Philadelphia, Pa.), 2010-10, Vol.50 (10), p.2220-2232 [Periódico revisado por pares]

Malden, USA: Blackwell Publishing Inc

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Título:
Cost-effectiveness of screening the US blood supply for Trypanosoma cruzi
Autor: Agapova, Maria ; Busch, Michael P. ; Custer, Brian
Assuntos: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Animals ; Biological and medical sciences ; Blood Donors - statistics & numerical data ; Blood Transfusion - economics ; Blood Transfusion - statistics & numerical data ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; Chagas Disease - prevention & control ; Cost-Benefit Analysis ; Human viral diseases ; Humans ; Infectious diseases ; Mass Screening - economics ; Mass Screening - methods ; Medical sciences ; Transfusion Reaction ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Trypanosoma cruzi ; Trypanosoma cruzi - isolation & purification ; United States ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids
É parte de: Transfusion (Philadelphia, Pa.), 2010-10, Vol.50 (10), p.2220-2232
Notas: istex:558F26C1A75997F7AB48CFA7AA911AF1013F62A8
ArticleID:TRF2686
ark:/67375/WNG-548M9KK2-9
No related papers have been published from this study. Some of the results reported in this article have appeared in the abstract entitled, “Cost‐effectiveness of screening the US blood supply for
presented at the 2009 AABB Annual Meeting.
This work was funded by an intramural Blood Systems, Inc. grant.
Trypanosoma cruzi
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Descrição: BACKGROUND: Trypanosoma cruzi, the etiologic agent of Chagas disease, is a potential threat to transfusion recipients in the United States. The cost‐effectiveness of seven testing strategies was evaluated against no testing and hierarchically in incremental analysis. Donor‐specific strategies included testing donors born in endemic countries, testing all donors a specific number of times, or testing all donors every time. Component‐specific strategies are based on screening platelet‐containing donations. STUDY DESIGN AND METHODS: A decision analytic model simulated the lifetime cost (US dollars) and health outcomes (quality‐adjusted life‐years [QALYs]) of two hypothetical cohorts of blood recipients, an all‐ages and a younger subset, from a 2007 societal perspective. Model variable values were obtained from US screening data, Blood Systems Laboratory, the Health Care Utilization Project, and published literature. RESULTS: For the all‐ages cohort, compared to no testing, the cost‐effectiveness of testing all donors one time was $757,000 per QALY, all donors two times $970,000 per QALY, and universal testing $1.36 million per QALY. In the all‐ages and the younger transfused populations, testing donors with geographical exposure was most cost‐effective ($173,000 and $29,000/QALY, respectively). The most influential variables in the model were related to characteristics of the transfused population: survival and health state utilities. With respect to T. cruzi variables, results were most sensitive to seroprevalence and transmissibility. CONCLUSION: Selective T. cruzi screening generates nearly the same effectiveness as universal screening, but at a reduced cost. Outcomes and associated costs of Chagas disease take longer to materialize than the average life expectancy of transfusion recipients.
Editor: Malden, USA: Blackwell Publishing Inc
Idioma: Inglês

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Cost-effectiveness of screening the US blood supply for Trypanosoma cruzi

Agapova, Maria ; Busch, Michael P. ; Custer, Brian

Malden, USA: Blackwell Publishing Inc

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