Cost-effectiveness of solvent/detergent-treated fresh-frozen plasma

• Published in: Vox sanguinis Vol. 85; no. 2; pp. 88 - 95
• Main Authors: Riedler, G. F., Haycox, A. R., Duggan, A. K., Dakin, H. A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.08.2003; Blackwell
• Subjects: Algorithms; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Transfusion - economics; Blood Transfusion - standards; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Cost-Benefit Analysis; cost-effectiveness analysis; detergent-treated fresh-frozen plasma; Detergents; fresh-frozen plasma; Humans; Medical sciences; Models, Economic; Plasma - microbiology; solvent; Solvents; Sterilization - methods; Transfusion Reaction; transfusion reactions; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Human; Prevention; Detergent; Treatment; Transfusion; Hematology; Fresh frozen plasma; Technology; Health economy; Complication; Solvent; Cost efficiency analysis
• ISSN: 0042-9007; 1423-0410
• DOI: 10.1046/j.1423-0410.2003.00329.x

Background and Objectives Although transfusion‐transmitted infections are rare, non‐infectious complications occur relatively frequently. Solvent/detergent‐treated fresh‐frozen plasma (SD‐FFP) has been shown to reduce the frequency of both types of complication, although previous economic evaluations failed to consider non‐infective events and subsequently underestimated the benefits of SD‐FFP. Materials and Methods A time‐series analytical model was used to estimate the incremental cost/life year saved for SD‐FFP compared with untreated FFP, having controlled for post‐transfusion mortality and patient age. Various infective and non‐infective transfusion‐related complications were considered. Results The discounted cost/life year saved for SD‐FFP use in the UK was £22 728 [95% confidence interval (95% CI): £22 604–22 853] for neonates and £98 465 (95% CI: £97 924–99 005) for patients aged 70. The cost‐effectiveness ratio was below £50 000/life year saved for patients ≤ 48 years of age, and below £30 000/life year saved for those ≤ 21 years of age. In transfusion recipients with no significant morbidity, the cost‐effectiveness ratio was £12 335 for neonates and £61 692 for 70‐year olds. The most important driver of cost‐effectiveness was transfusion‐related acute lung injury (TRALI), on account of its relatively high incidence and mortality rate. Conclusions Previous analyses greatly underestimated the cost‐effectiveness of SD‐FFP. Inclusion of non‐infectious complications suggests that SD‐FFP is cost‐effective in patients ≤ 48 years of age and in older patients with good clinical prognosis, which may justify the wider use of this technology.