The cost‐effectiveness of introducing nucleic acid testing to test for hepatitis B, hepatitis C, and human immunodeficiency virus among blood donors in Sweden

Abstract

Using ID-NAT for testing against HBV, HCV, and HIV among blood donors leads to cost-effectiveness ratios that are far beyond what is usually considered cost-effective. The main reason for this is that with current methods, the risks for virus transmission are very low in Sweden.

Cost Savings Associated with Testing of Antibodies, Antigens, and Nucleic Acids for Diagnosis of Acute HIV Infection

“…In this study, total ID-NAT costs $14 per test. However, others have reported the cost of this assay (including technician time and equipment) to be $14 to $49 per test (14,22,46); thus, costs for ID-NAT are reported as a range. The cost for the HIV Combo assay is reported to be $4.86 per test.…”

“…Prevention of these infections would likely prevent additional transmissions and continue to result in cost savings, but we did not consider those secondary prevented transmissions in this cost calculation. In comparison, using the HIV Combo assay to evaluate this entire cohort would have cost $13,335 and ID-NAT would have cost $38,416 to 134,897 (14,46). The difference between these screening costs remains a fraction of the potential savings from averted new transmissions.…”

“…Previous papers have evaluated the cost-effectiveness of ID-NAT compared to other methods. In this article, we used costs to illustrate the potential impact of missed diagnoses of acute HIV infection (14,46).…”

Current concepts in molecular testing

“…As shown in many developed countries, NAT screening for HBV, HCV and HIV is not cost-effective, being the decision to use them justified as a health priority for the society [16,17]. Paradoxically, NAT screening may prove to be financially reasonable in developing countries, where the incidence of these agents in the blood donor population is higher than in the countries that first introduced NAT screening, providing a higher yield of WP donations blocked by the test.…”

Fear of anemia or why don’t we afraid of blood transfusion?

“…Риск передачи с кровью ин-фекций уменьшился до того, что впервые за 14-летний период переливания крови в Великобритании в 2010 г. не было отмечено подтвержденных случаев заражения реци-пиентов инфекцией после переливания компонентов до-норской крови [16]. Хотя эти усилия оказались весьма эф-фективными в достижении своей цели на каком-то этапе [11], появление новых инфекционных агентов, таких как вирус иммунодефицита человека и возбудитель болезни Крейтцфельда-Якоба, позволяет оспаривать возмож-ность абсолютной безопасности относительно передачи инфекционных агентов.…”