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Economic Evaluation of Nucleic Acid Testing for Screening of Blood Donations for Thalassemia Patients (ECONAT) in Western India

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Background

Transfusion Transmitted infections(TTI) are of significant concern for blood safety. The thalassemia patients who receive multiple transfusions are at an increased risk of TTIs and the Nucleic Acid Test (NAT ) has been advocated for safe blood. Though NAT can reduce the window period compared to serology, cost is a constraint.

Methods

The thalassemia patient and NAT yield data from the centralized NAT lab in AIIMS Jodhpur was evaluated for cost-effectiveness using the Markov model. The incremental cost-effectiveness ratio (ICER) was calculated by dividing the difference between the cost for NAT and the cost of medical management of TTI-related complications by the product of the difference in utility value of a TTI health state with time and Gross National Income(GNI) per capita.

Results

Out of the 48,762 samples tested by NAT, 43 samples were discriminated NAT yield all of which were reactive for Hepatitis B (NAT yield of 1:1134). There was no HCV and HIV NAT yield despite HCV being the most prevalent TTI in this population. The cost of this intervention was INR 5,85,14,400. The number of lifetime QALY saved was 1.38 years. The cost of medical management is INR 82,19,114. Therefore the ICER for intervention is INR 3,64,45,860 per QALY saved which is 274 times the GNI per capita of India.

Conclusions

The provision of IDNAT-tested blood for thalassemia patients in Rajasthan state was not found to be cost-effective. Measures to bring down the cost or alternative options to increase blood safety should be explored.

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Acknowledgements

We would like to acknowledge the contribution of Mr. Manish Choudhary, State Coordination Officer (Blood Cell), NHM Rajasthan and Mr. Tousif Ashraf, Senior Application specialist, Hemogenomics private limited, India for their contribution in implementation of centralized NAT testing and data collection for the project.

Funding

The project for centralized NAT testing has received funding from National Health Mission, Rajasthan.

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Authors and Affiliations

  1. Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, 342005, Jodhpur, India

    Puneeth Babu Anne, Anubhav Gupta, Archana Bajpayee & Vasanth Asirvatham

  2. All India Institute of Medical Sciences, 342005, Jodhpur, India

    Sanjeev Misra & Suresh Kumar Sharma

  3. Department of General Medicine, All India Institute of Medical Sciences, 342005, Jodhpur, India

    Mahendra Kumar Garg

  4. Department of Immunohematology and Transfusion Medicine, S.M.S. Medical college, 302004, Jaipur, India

    Sunita Bundas

  5. Department of Immunohematology and Transfusion Medicine, Dr. S. N. Medical College, 342003, Jodhpur, India

    Manju Bohra

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Contributions

Study conception and design: Dr. Puneeth Babu Anne, Dr. Archana Bajpayee, Dr. Sanjeev Misra, Dr. Mahendra Kumar Garg. Data collection: Dr. Puneeth Babu Anne, Dr. Sunita Bundas, Dr. Manju Bohra. Analysis and interpretation of results: Dr. Puneeth Babu Anne, Dr. Archana Bajpayee, Dr. Suresh Kumar Sharma. Draft manuscript preparation: Dr. Puneeth Babu Anne, Dr. Anubhav Gupta. All authors reviewed the results and approved the final version of the manuscript.

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Correspondence to Archana Bajpayee.

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Anne, P.B., Gupta, A., Misra, S. et al. Economic Evaluation of Nucleic Acid Testing for Screening of Blood Donations for Thalassemia Patients (ECONAT) in Western India. Indian J Hematol Blood Transfus 39, 317–324 (2023). https://doi.org/10.1007/s12288-022-01564-8

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