Health economic implications of testing blood donors in South Africa for HTLV 1 & 2 infection

Autor:	Ravi Reddy, Marion Vermeulen, Charlotte Ingram, Colwyn Poole, Karin van den Berg, Wendy Sykes, Brian Custer
Rok vydání:	2019
Předmět:	medicine.medical_specialty Blood transfusion Total cost Cost-Benefit Analysis medicine.medical_treatment Blood Donors 030204 cardiovascular system & hematology Article South Africa 03 medical and health sciences 0302 clinical medicine Economic assessment Health care medicine Humans health care economics and organizations Human T-lymphotropic virus 1 Hematologic Tests Cost–benefit analysis business.industry Human T-lymphotropic virus 2 Transfusion Reaction Hematology General Medicine Budget impact Clinical disease HTLV-I Infections HTLV-II Infections Emergency medicine Blood supply business 030215 immunology
Zdroj:	Vox Sang
ISSN:	1423-0410 0042-9007
DOI:	10.1111/vox.12788
Popis:	Background and objectives Currently, HTLV screening is not performed in South Africa (SA). This report describes an economic assessment (budget impact and cost-effectiveness) of implementing different HTLV screening strategies. Methods A modified version of the Alliance of Blood Operators risk-based decision-making framework was used to assess the risk and consequences of HTLV in the blood supply in SA. We developed a deterministic model of the cost and consequences of four screening strategies: none, universal, all donors once and first time donors only assuming a transfusion-transmission (TT) efficiency of 10% and a manifestation of clinical disease of 6%. Results Unscreened blood results in 3·55 symptomatic TT-HTLV cases and a total healthcare cost of Rand (R)3 446 950 (US Dollars (USD)229 800) annually. Universal screening would cost R24 000 000 (USD1 600 000) per annum and prevent 3·54 (99·8%) symptomatic TT-HTLV cases in the first year and 0·55 (98·4%) symptomatic TT-HTLV cases in the second year at a cost per TT-HTLV prevented of R6 780 000 (USD450 000) in year one and R43 254 000 (USD2 890 000) in year two. Screening all donors once would cost R16,200,000 (USD1 080 000) or R4 600 000 (USD306 000) per symptomatic TT-HTLV infection prevented in year one. Total costs decrease to R5 100 000 (USD340 000) in year 2 but the cost per TT-HTLV prevented increases to R10 700 000 (USD713 333). Conclusion This analysis contributed to the decision not to implement HTLV screening as the healthcare budget and particularly the budget for blood transfusion in SA is insufficient to provide appropriate treatment. Arguably, available resources can be more efficiently utilized in other healthcare programs.
Databáze:	OpenAIRE
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