An economic reappraisal of hepatitis B virus testing strategy for blood donors in Taiwan

• Published in: Vox sanguinis Vol. 116; no. 5; pp. 564 - 573
• Main Authors: Matanhire, Tapiwa Blessing, Lin, Shi‐Woei
• Format: Journal Article
• Language: English
• Published: Amsterdam S. Karger AG 01.05.2021
• Subjects: Antigens; Blood; Blood & organ donations; Blood donors; blood safety; Cost analysis; cost‐effectiveness analysis; HBsAg test; Hepatitis; Hepatitis B; Hepatitis B surface antigen; hepatitis B virus; Markov chains; Markov model; NAT testing; Nucleic acids; Viruses; Taiwan
• ISSN: 0042-9007; 1423-0410
• DOI: 10.1111/vox.13045

Background and objectives Taiwan is among the few hepatitis B virus (HBV) high‐endemic countries that implement universal mini‐pool nucleic acid testing (MP‐NAT) and hepatitis B surface antigen (HBsAg) testing together with confirmatory individual donor nucleic acid testing (ID‐NAT) for its blood supply since 2013. The aim of this study was to reappraise the value of HBsAg test in Taiwan’s HBV testing strategy. Materials and methods A Markov model was constructed, and cost‐effectiveness analysis was conducted in order to reappraise the existing HBV screening strategy in Taiwan. Results The incremental cost‐effectiveness ratio (ICER) for the current testing strategy in Taiwan was estimated to be $US 443 154 per quality‐adjusted life year (QALY) gained. This is almost six times the willingness‐to‐pay (WTP) threshold that reflects local preferences. Conclusion Universal HBsAg and MP‐8‐NAT together with confirmatory ID‐NAT testing prevents a significant amount of HBV infections from entering the Taiwan blood supply. However, this comes at a disproportionate increase in cost.