Financial analysis of large-volume delayed sampling to reduce bacterial contamination of platelets
- 1 May 2020
- journal article
- research article
- Published by Wiley in Transfusion
- Vol. 60 (5), 997-1002
- https://doi.org/10.1111/trf.15773
Abstract
BACKGROUND Effective and financially viable mitigation approaches are needed to reduce bacterial contamination of platelets in the US. Expected costs of large-volume delayed sampling (LVDS), which would be performed by a blood center prior to shipment to a hospital, were compared to those of pathogen reduction (PR), point-of-release testing (PORt), and secondary bacterial culture (SBC). METHODS Using a Markov-based decision-tree model, the financial and clinical impact of implementing all variants of LVDS, PR, PORt, and SBC described in FDA guidance were evaluated from a hospital perspective. Hospitals were assumed to acquire leukoreduced apheresis platelets, with LVDS adding $30 per unit. Monte Carlo simulations were run to estimate the direct medical costs for platelet acquisition, testing, transfusion, and possible complications associated with each approach. Input parameters, including test sensitivity and specificity, were drawn from existing literature and costs (2018US$) were based on a hospital perspective. A one-way sensitivity analysis varied the assumed additional cost of LVDS. RESULTS Under an approach of LVDS (7-day), the total cost per transfused unit is $735.78, which falls between estimates for SBC (7-day) and PORt. Assuming 20,000 transfusions each year, LVDS would cost $14.72 million annually. Per-unit LVDS costs would need to be less than $22.32 to be cheaper per transfusion than all other strategies, less than $32.02 to be cheaper than SBC (7-day), and less than $196.19 to be cheaper than PR (5-day). CONCLUSIONS LVDS is an effective and cost-competitive approach, assuming additional costs to blood centers and associated charges to hospitals are modest.This publication has 13 references indexed in Scilit:
- Prevention of transfusion-transmitted infectionsBlood, 2019
- Financial impact of alternative approaches to reduce bacterial contamination of platelet transfusionsTransfusion, 2019
- The epidemiology of bacterial culture-positive and septic transfusion reactions at a large tertiary academic center: 2009 to 2016Transfusion, 2018
- Implementation of secondary bacterial culture testing of platelets to mitigate residual risk of septic transfusion reactionsTransfusion, 2018
- Bacterial screening of platelet components by National Health Service Blood and Transplant, an effective risk reduction measureTransfusion, 2017
- Detection of septic transfusion reactions to platelet transfusions by active and passive surveillanceBlood, 2016
- Platelet Transfusion: A Clinical Practice Guideline From the AABBAnnals of Internal Medicine, 2015
- Constructing a model: economic evaluations in transfusion medicine, Part 3Transfusion, 2013
- Bacterial contamination of blood: lessons from the past and road map for the futureTransfusion, 2004
- Transfusion‐transmitted bacterial infectionin the United States, 1998 through 2000Transfusion, 2001