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Economic Analyses of Pathogen-Reduction Technologies in Blood Transfusion: A Systematic Literature Review

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Abstract

Background

Technologies used in the processing of whole blood and blood component products, including pathogen reduction, are continuously being adopted into blood transfusion workflows to improve process efficiencies. However, the economic implications of these technologies are not well understood. With the advent of these new technologies and regulatory guidance on bacterial risk-control strategies, an updated systematic literature review on this topic was warranted.

Objective

The objective of this systematic literature review was to summarize the current literature on the economic analyses of pathogen-reduction technologies (PRTs).

Methods

A systematic literature review was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to identify newly published articles in PubMed, MEDLINE Complete, and EconLit from 1 January 2000 to 17 July 2019 related to economic evaluations of PRTs. Only full-text studies in humans published in English were included in the review. Both budget-impact and cost-effectiveness studies were included; common outcomes included cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs).

Results

The initial searches identified 433 original abstracts, of which 16 articles were included in the final data extraction and reporting. Seven articles presented cost-effectiveness analyses and nine assessed budget impact. The introduction of PRT increased overall costs, and ICER values ranged widely across cost-effectiveness studies, from below $US150,000/QALY to upwards of $US20,000,000/QALY. This wide range of results was due to a multitude of factors, including comparator selection, target patient population, and scenario analyses included.

Conclusions

Overall, the results of economic evaluations of bacterial risk-control strategies, regardless of mechanism, were highly dependent on the current screening protocols in place. The optimization of blood transfusion safety may not result in decisions made at the willingness-to-pay thresholds commonly seen in pharmaceutical evaluations. Given the critical public health role of blood products, and the potential safety benefits introduced by advancements, it is important to continue building this body of evidence with more transparency and data source heterogeneity. This updated literature review provides global context when making local decisions for the coverage of new and emerging bacterial risk-control strategies.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Laura T. Pizzi.

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Funding

No sources of funding were used to conduct this study or prepare this manuscript.

Conflict of interest

Dr. Pizzi and Ms. Prioli have received research funding from Cerus Corporation. Dr. LaFontaine is a post-doctoral fellow with Sanofi and Rutgers University. Dr. Herman, Dr. Yuan, and Ms. Shah have no conflicts of interest that are directly relevant to the content of this article.

Availability of data and material

Aggregated literature search and article review results are available from the corresponding author upon reasonable request.

Ethics approval

As this study involves a systematic literature review and does not constitute human subjects research, it was not submitted for institutional review board assessment.

Consent

Not applicable.

Author contributions

PRL and JY participated in all aspects of study conception, design, and literature searches, and the drafting, revision, and final review of the manuscript. KMP provided editorial review of the manuscript with a focus on the introduction and results sections. PS aided in preliminary literature searches and provided editorial review of the manuscript with a focus on the methods section. JHH aided in search strategy development and provided editorial review of the manuscript. LTP guided study conception and design, manuscript development, and provided editorial review of the manuscript with a focus on the results and discussion sections.

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LaFontaine, P.R., Yuan, J., Prioli, K.M. et al. Economic Analyses of Pathogen-Reduction Technologies in Blood Transfusion: A Systematic Literature Review. Appl Health Econ Health Policy 19, 487–499 (2021). https://doi.org/10.1007/s40258-020-00612-6

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