Premium
Cost effectiveness of adding nucleic acid testing to hepatitis B , hepatitis C , and human immunodeficiency virus screening of blood donations in Z imbabwe
Author(s) -
Mafirakureva Nyashadzaishe,
Mapako Tonderai,
Khoza Star,
Emmanuel Jean C.,
Marowa Lucy,
Mvere David,
Postma Maarten J.,
van Hulst Marinus
Publication year - 2016
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.13858
Subject(s) - medicine , nat , serology , hepatitis b virus , virology , hepatitis c virus , hepatitis b , immunology , virus , antibody , computer network , computer science
BACKGROUND The aim of this study was to assess the cost effectiveness of introducing individual‐donation nucleic acid testing (ID‐NAT), in addition to serologic tests, compared with the exclusive use of serologic tests for the identification of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) I and II among blood donors in Zimbabwe. STUDY DESIGN AND METHODS The costs, health consequences, and cost effectiveness of adding ID‐NAT to serologic tests, compared with serologic testing alone, were estimated from a health care perspective using a decision‐analytic model. RESULTS The introduction of ID‐NAT in addition to serologic tests would lower the risk of HBV, HCV, and HIV transmission to 46.9, 0.3, and 2.7 per 100,000 donations, respectively. ID‐NAT would prevent an estimated 25, 6, and 9 HBV, HCV, and HIV transfusion‐transmitted infections per 100,000 donations, respectively. The introduction of this intervention would result in an estimated 212 quality‐adjusted life‐years (QALYs) gained. The incremental cost‐effectiveness ratio is estimated at US$17,774/QALY, a value far more than three times the gross national income per capita for Zimbabwe. CONCLUSION Although the introduction of NAT could further improve the safety of the blood supply, current evidence suggests that it cannot be considered cost effective. Reducing the test costs for NAT through efficient donor recruitment, negotiating the price of reagents, and the efficient use of technology will improve cost effectiveness.