Addressing the risk of bacterial contamination in platelets: a hospital economic perspective

Li, Justin W.; Brecher, Mark E.; Jacobson, Jay A.; Harm, Sarah; Chen, Dorothy; El-Gamil, Audrey M.; Dobson, Al; Mintz, Paul D.

doi:10.1111/trf.14216

Cited by 26 publications

(33 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, when narrowly assessed within the confines of bacterial risk of platelets, high cost of PR (approx. $100 per unit) is a counterpoint for blood centers and hospitals alike . Although easy from a hospital perspective, PR is also labor and resource intensive for the blood supplier.…”

Section: Discussionmentioning

confidence: 99%

“…However, PORt is neither rapid nor technically simple, incurring long waiting periods (30‐60 min) for turnaround of results. Although less expensive than PR, the complete cost (including kit purchase and labor) is approximately $25 to $38 per test, which is not insignificant. Furthermore, one needs to be able to anticipate daily platelet transfusion needs, given that the testing must be performed within 24 hours of transfusion.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Implementation of secondary bacterial culture testing of platelets to mitigate residual risk of septic transfusion reactions

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Implementation of secondary bacterial culture testing of platelets to mitigate residual risk of septic transfusion reactions

et al. 2018

View full text Add to dashboard Cite

show abstract

“…It was assumed that PR would eliminate the need for (and costs of) primary culture at the blood collection facility, irradiation, and Zika testing. However, because patients treated with PR PLTs require an increased number of transfusions to achieve a fixed posttransfusion corrected count increment, an inflation factor of 1.14 was incorporated …”

Section: Methodsmentioning

confidence: 99%

“…The PORt strategy was modeled on the Platelet Pan Genera Detection Test (Verax Biomedical, Marlborough, MA), which is a rapid test cleared by the FDA as a safety measure . The “safety measure” label allows for extension of platelet dating through Day 7 .…”

Section: Methodsmentioning

confidence: 99%

“…Standard product and nonproduct costs were obtained from published literature and were based on a hospital perspective. In the absence of PR, it was assumed that the hospital service received leukoreduced apheresis PLTs ($555.75), which then underwent irradiation and Zika testing . Nonproduct costs included expenses associated with the blood bank as well as transfusion itself and were based on a lean process analysis of PLT transfusion at a large academic medical center in the United States .…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Financial impact of alternative approaches to reduce bacterial contamination of platelet transfusions

et al. 2019

View full text Add to dashboard Cite

BACKGROUND Bacterial contamination of platelets remains the leading infectious risk from blood transfusion. Pathogen reduction (PR), point‐of‐release testing (PORt), and secondary bacterial culture (SBC) have been proposed as alternative risk control strategies, but a comprehensive financial comparison has not been conducted. STUDY DESIGN AND METHODS A Markov‐based decision tree was constructed to model the financial and clinical impact of PR, PORt, and SBC, as well as a baseline strategy involving routine testing only. Hospitals were assumed to acquire leukoreduced apheresis platelets on Day 3 after collection, and, in the base case analysis, expiration would occur at the end of Day 5 (PR and SBC) or 7 (PORt). Monte Carlo simulations assessed the direct medical costs for platelet acquisition, testing, transfusion, and possible complications. Input parameters, including test sensitivity and specificity, were drawn from existing literature, and costs (2018 US dollars) were based on a hospital perspective. RESULTS The total costs per unit acquired by the hospital under the baseline strategy, PR, PORt, and SBC were $651.45, $827.82, $686.33, and $668.50, respectively. All risk‐reduction strategies decreased septic transfusion reactions and associated expenses, with the greatest reductions from PR. PR would add $191.09 in per‐unit acquisition costs, whereas PORt and SBC would increase per‐unit testing costs by $31.79 and $17.26, respectively. Financial outcomes were sensitive to platelet dating; allowing 7‐day storage with SBC would lead to a cost savings of $12.41 per transfused unit. Results remained robust in probabilistic sensitivity analyses. CONCLUSIONS All three strategies are viable approaches to reducing bacterially contaminated platelet transfusions, although SBC is likely to be the cheapest overall.

show abstract

Economic Implications of Pathogen Reduced and Bacterially Tested Platelet Components: A US Hospital Budget Impact Model

Prioli

Karp

Lyons

et al. 2018

Appl Health Econ Health Policy

View full text Add to dashboard Cite

BackgroundUS FDA draft guidance includes pathogen reduction (PR) or secondary rapid bacterial testing (RT) in its recommendations for mitigating risk of platelet component (PC) bacterial contamination. An interactive budget impact model was created for hospitals to use when considering these technologies.MethodsA Microsoft Excel model was built and populated with base-case costs and probabilities identified through literature search and a survey of US hospital transfusion service directors. Annual costs of PC acquisition, testing, wastage, dispensing/transfusion, sepsis, shelf life, and reimbursement for a mid-sized hospital that purchases all of its PCs were compared for four scenarios: 100% conventional PCs (C-PC), 100% RT-PC, 100% PR-PC, and 50% RT-PC/50% PR-PC.ResultsAnnual total costs were US$3.64, US$3.67, and US$3.96 million when all platelets were C-PC, RT-PC, or PR-PC, respectively, or US$3.81 million in the 50% RT-PC/50% PR-PC scenario. The annual net cost of PR-PC, obtained by subtracting annual reimbursements from annual total costs, is 6.18% above that of RT-PC. Maximum usable shelf lives for C-PC, RT-PC, and PR-PC are 3.0, 5.0, and 3.6 days, respectively; hospitals obtain PR-PC components earliest at 1.37 days.ConclusionThe model predicts minimal cost increase for PR-PC versus RT-PC, including cost offsets such as elimination of bacterial detection and irradiation, and reimbursement. Additional safety provided by PR, including risk mitigation of transfusion-transmission of a broad spectrum of viruses, parasites, and emerging pathogens, may justify this increase. Effective PC shelf life may increase with RT, but platelets can be available sooner with PR due to elimination of bacterial detection, depending on blood center logistics.

show abstract

Addressing the risk of bacterial contamination in platelets: a hospital economic perspective

Cited by 26 publications

References 23 publications

Implementation of secondary bacterial culture testing of platelets to mitigate residual risk of septic transfusion reactions

Implementation of secondary bacterial culture testing of platelets to mitigate residual risk of septic transfusion reactions

Financial impact of alternative approaches to reduce bacterial contamination of platelet transfusions

Economic Implications of Pathogen Reduced and Bacterially Tested Platelet Components: A US Hospital Budget Impact Model

Contact Info

Product

Resources

About