Cost-effectiveness of transfusing virus-inactivated plasma instead of standard plasma.

摘要

BACKGROUND: Virus inactivation of plasma intended for transfusion avoids the transmission of hepatitis B virus, hepatitis C virus, and HIV. However, because most plasma recipients also receive other blood components concomitantly, the procedure reduces but cannot eliminate the risk of transfusion-transmitted infection. As virus-inactivated plasma has just been licensed in the United States and other countries, a cost-effectiveness analysis is pertinent. STUDY DESIGN AND METHODS: A Monte Carlo simulation of a Markov model representing the possible outcomes of plasma recipients was used to derive costs and utilities of transfusing virus-inactivated plasma instead of standard plasma. Probability distributions for patients' age and sex and for the number of blood components transfused per case were determined in 924 plasma recipients in a tertiary-care hospital. Other values were obtained from the medical literature. Results of the baseline and sensitivity analyses are the mean (+/- SD) of 10 simulations with 10(7) patients per simulation. RESULTS: In the baseline analysis, transfusing virus-inactivated plasma instead of standard plasma prolonged the quality-adjusted survival by 1 hour and 11 minutes per patient, at a cost-effectiveness ratio of