Skip to main content
SpringerLink
Log in

The Role of Cost-Effectiveness Analysis in Defining Transfusion Medicine Policy

  • Chapter
Risk Management in Blood Transfusion: The Virtue of Reality

Part of the book series: Developments in Hematology and Immunology ((DIHI,volume 34))

  • 85 Accesses

Abstract

Government officials, administrators and physicians charged with providing a safe blood supply face a difficult dilemma. After enduring decades of hepatitis C (HCV) risk without effective means to detect carriage of the causative agent and after discovering the havoc that can be wrought by a lethal, blood-borne immunodeficiency virus with a long incubation period, enhanced donor screening and testing tools have reduced infectious disease risks in the allogeneic blood supply of industrialized nations to lower levels than ever enjoyed previously. At the same time, however, new opportunities for increasing the safety of the blood supply pose new risks and may consume large amounts of healthcare resources. Choosing the course to be followed in these new waters is not simple.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Busch MP, Young MJ, Samson SM, Mosley JW, Ward JW, Perkins HA, and the Transfusion Safety Study Group. Risk of human immunodeficiency virus (HIV) transmission by blood transfusions before the implementation of HIV-1 antibody screening. Transfusion 1991 ;31:4–11.

    Google Scholar 

  2. Lackritz EM, Satten GA, Aberle-Grasse J, et al. Estimated risk of HIV transmission by screened blood in the United States. N Engl J Med 1995;333:1721–25.

    Article  PubMed  CAS  Google Scholar 

  3. Schreiber GB, Busch MP, Kleinman SH, Korelitz JJ. The risk of transfusion-transmitted viral infections. N Engl J Med 1996;334:1685–90.

    Article  PubMed  CAS  Google Scholar 

  4. Busch MP, Korelitz JJ, Kleinman SH, Lee SR, AuBuchon JP, Schreiber GB. Declining value of alanine aminotransferase in screening of blood donors to prevent posttransfusion hepatitis B and C vims infection. The Retrovirus Epidemiology Donor Study. Transfusion 1995;35:903–10.

    Article  PubMed  CAS  Google Scholar 

  5. Nelson KE, Ahmed F, Stambolis V, Ness PM, Yawn D, McAlister H. Incident hepatitis C virus (HCV) and hepatitis virus (HBV) infections in transfused cardiac surgery patients: Infection rates during different methods of donor screening. In Infectious disease testing for blood transfusions. Consensus development conference. Bethesda: National Institutes of Health, 1995.

    Google Scholar 

  6. Linden JV, Paul B, Dressier KP. A report of 104 transfusion errors in New York State. Transfusion. 1992;32:601–06.

    Article  PubMed  CAS  Google Scholar 

  7. Canadian Coordinating Office for Health Technology Assessment. Leukoreductiond costs. Ottawa: Canadian Coordinating Office for Health Technology Assessment (CCOHTA); 1998.

    Google Scholar 

  8. Birkmeyer JD, AuBuchon IP, Littenberg B, O’Connor GT, Nease RF, Nugent WC, Goodnough LT. The cost-effectiveness of preoperative autologous donation in coronary bypass surgery. Ann Thoracic Surg 1994;57:161–69.

    Article  CAS  Google Scholar 

  9. Birkmeyer JD, Goodnough LT, AuBuchon JP, Noordsij PG, Littenberg B. The cost-effectiveness of preoperative autologous blood donation in total hip and knee replacement. Transfusion 1993;33:544–51.

    Article  PubMed  CAS  Google Scholar 

  10. Larocque BJ, Gilbert K, Brien WF. A point score system for predicting the likelihood of blood transfusion after hip or knee arthroplasty. Transfusion 1997;37:463–67.

    Article  PubMed  CAS  Google Scholar 

  11. Nuttall GA, Sazntrach PJ, Oliver WC Jr et al. A prospective randomized trial of the surgical blood order equation for ordering red cells for total hips arthroplasty patients. Transfusion 1998;38:828–33.

    Article  PubMed  CAS  Google Scholar 

  12. Etchason J, Petz L, Keeler E. et al. The cost effectiveness of preoperative autologous blood donations. N Engl J Med 1995:332:719–24.

    Article  PubMed  CAS  Google Scholar 

  13. Popovsky MA, Whitaker B, Arnold NL. Severe outcomes of allogeneic and autologous blood donation: frequency and characterization. Transfusion 1995;35:734–37.

    Article  PubMed  CAS  Google Scholar 

  14. AuBuchon JP, Popovsky MA. The safety of preoperative autologous blood donation in the non-hospital setting. Transfusion 1991;31:513–17.

    Article  PubMed  CAS  Google Scholar 

  15. Healy JC, Frankforter SA, Graves BK, Reddy RL, Beck JR. Preoperative autologous blood donation in total-hip arthroplasty. A cost-effectiveness analysis. Arch Pathol Lab Med 1994;118:465–70.

    PubMed  CAS  Google Scholar 

  16. Blumberg N, Kirkley S, Panzer R, Heal J. A cost analysis of autologous compare to autologous plus allogeneic blood transfusions in hip replacement surgery. Br J Haematol 1994;87(Suppl. 1):72 (abstract 285).

    Article  Google Scholar 

  17. AuBuchon JP, Gettinger A, Littenberg B. Physician determinants of ordering preoperative autologous donation. Vox Sang 1994;66:176–81.

    Article  PubMed  CAS  Google Scholar 

  18. Goodnough LT, Monk TG, Brecher ME. Autologous blood procurement in the surgical setting: Lessons learned in the last 10 years. Vox Sang 1996;71:133–41.

    Article  PubMed  CAS  Google Scholar 

  19. Kanter MH, van Maanen D, Anders KH, Castro F, Mya WW, Clark K. Preoperative autologous blood donations before elective hysterectomy. JAMA 1996;276:798–801.

    Article  PubMed  CAS  Google Scholar 

  20. Brecher ME, Rosenfeld M. Mathematical and computer modeling of acute normovolemic hemodilution. Transfusion 1994;34:176–79.

    Article  PubMed  CAS  Google Scholar 

  21. Umlas J, Foster RR, Dalai SA, O’Leary SM, Garcia L, Kruskall MS. Red cell loss following orthopedic surgery: the case against postoperative blood salvage. Transfusion 1994;34:402–06.

    Article  PubMed  CAS  Google Scholar 

  22. Cazzola M, Mercuriali F, Brugnara C. Use of recombinant human erythropoietin outside the setting of uremia. Blood 1997;89:4248–67.

    PubMed  CAS  Google Scholar 

  23. Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. The Trial To Reduce Alloimmunization To Platelets Study Group. N Engl J Med 1997;337:1861–69.

    Article  Google Scholar 

  24. Jensen LS, Grunet N, Hanberg-Sorensen F, Jorgensen J. Cost-effectiveness of blood transfusion and white cell reduction in elective colorectal surgery. Transfusion 1995; 35:719–22.

    Article  PubMed  CAS  Google Scholar 

  25. Bowden RA, Slichter SJ, Savers M et al. A comparison of filtered leukocyte-reduced and cytomegalovirus (CMV) seronegative blood products for the prevention of transfusion associated CMV infection after bone marrow transplant. Blood 1995;86: 3598–603.

    PubMed  CAS  Google Scholar 

  26. Lapierre V, Auperin A, Tiberghien P. Transfusion-induced immunomodulation following cancer surgery: Fact or fiction? J Nat Cancer Inst 1998;90:573–80.

    Article  PubMed  CAS  Google Scholar 

  27. Busch MP, Korelitz JJ, Kleinman SH, Lee SR, AuBuchon JP, Schreiber GB and the Retrovirus Epidemiology in Donors Study (REDS). Declining yield of alanine aminotransferase for screening of blood donors for prevention of post-transfusion hepatitis B and C virus infection. Transfusion 1995;35:903–10.

    Article  PubMed  CAS  Google Scholar 

  28. Korelitz JJ, Busch MP, Kleinman SH, et al. Relationship between antibody to hepatitis B core antigen and retroviral infections in blood from volunteer donors. Transfusion 1996;36:232–37.

    Article  PubMed  CAS  Google Scholar 

  29. AuBuchon JP, Birkmeyer JD, Busch MP. Cost-effectiveness of human immunodeficiency vims-testing protocols for donated blood. Transfusion 1997;37:45–51.

    Article  PubMed  CAS  Google Scholar 

  30. Korelitz JJ, Busch MP, Williams AE for the Retrovirus Epidemiology Donor Study. Antigen testing for human immunodeficiency virus (HIV) and the magnet effect: Will the benefit of a new HIV test be offset by the numbers of higher-risk, test-seeking donors attracted to blood centers. Transfusion 1996;36:203–08.

    Article  PubMed  CAS  Google Scholar 

  31. Lynch TJ, Weinstein MJ, Tankersley DL, Fratantoni JC, Finalyson JS. Considerations of pool size in the manufacture of plasma derivatives. Transfusion 1996;36: 770–75.

    Article  PubMed  CAS  Google Scholar 

  32. Vamvakas EC, Taswell HF. Long-term survival after blood transfusion. Transfusion 1994;34:471–77.

    Article  PubMed  CAS  Google Scholar 

  33. AuBuchon JP, Birkmeyer JD. Safety and cost-effectiveness of solvent-detergent treated plasma. In search of a zero-risk blood supply. JAMA 1994;272:1210–14.

    Article  PubMed  CAS  Google Scholar 

  34. Schwartz LM. Woloshin S. Black WC. Welch HG. The role of numeracy in understanding the benefit of screening mammography. Ann Int Med 1997;127:966–72.

    Google Scholar 

  35. Russell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC, for the Panel on Cost-Effectiveness in Health and Medicine. The role of cost-effectiveness analysis in health and medicine. JAMA 1996;276:1172–77.

    Article  PubMed  CAS  Google Scholar 

  36. Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB, for the Panel on Cost-Effectiveness in Health and Medicine. Recommendations of the panel on cost-effectiveness in health and medicine. JAMA 1996;276:1253–58.

    Article  PubMed  CAS  Google Scholar 

  37. Morgan MG. Risk analysis and management. Sci Am 1993;269:32–35, 38–41.

    Google Scholar 

  38. Schneiderman LJ, Kaplan RM. Fear of dying and HIV infection vs Hepatitis B infection. Am J Public Health 1992;82:584–86.

    Article  PubMed  CAS  Google Scholar 

  39. Fowler FJ, Jr, Geary PD, Massagli MP, Weissman J, Epstein A. The role of reluctance to give up life in the measurement of the values of health states. Med Decis Making 1995;15:195–200.

    Article  PubMed  Google Scholar 

  40. Hadorn DC. Setting health care priorities in Oregon. Cost-effectiveness meets the rule of rescue. JAMA 1991;265:2218–25.

    Article  PubMed  CAS  Google Scholar 

  41. Hux JE, Leviton CM, Naylor CD. Prescribing propensity: Influence of life-expectancy gains and drug costs. J Gen Intern Med 1994;9:195–201.

    Article  PubMed  CAS  Google Scholar 

  42. Rose G. Sick individuals and sick populations. Int J Epidemiol 1985;14:32–38.

    Article  PubMed  CAS  Google Scholar 

  43. Infectious disease testing for blood transfusions. NIH Consensus Development Panel on Infectious Disease Testing for Blood Transfusions. JAMA 1995;274: 1374–79.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Pathology and Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA

    J. P. AuBuchon

Authors
  1. J. P. AuBuchon
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Blood Bank Noord Nederland, Groningen, The Netherlands

    C. Th. Smit Sibinga

  2. National Institutes of Health, Bethesda, MD, USA

    H. J. Alter

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

AuBuchon, J.P. (1999). The Role of Cost-Effectiveness Analysis in Defining Transfusion Medicine Policy. In: Sibinga, C.T.S., Alter, H.J. (eds) Risk Management in Blood Transfusion: The Virtue of Reality. Developments in Hematology and Immunology, vol 34. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-3009-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-3009-8_4

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-4822-9

  • Online ISBN: 978-1-4757-3009-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation