Health Economics in Blood Safety

Abstract

Health economic analyses measure the cost of illness, the cost of interventions to stop or prevent disease, and the health benefits which result from use of interventions. Methods relevant to blood safety are reviewed because assessing the health economics of microbial threats to transfusion is an important part of policy development. Both budget impact analyses, an assessment of cost to implement as well as any potential savings achieved in averted healthcare expenditures, and cost-effectiveness analyses which directly assess the health benefits achieved for the transfused population relative to costs, contribute to evidenced-based policy. As instructive examples, results from published health economic studies are provided for Zika virus, HTLV, Babesia microti, HIV, HBV, and HCV. The studies show high variability in the cost-effectiveness of specific interventions for microbial threats to blood safety. Available health economic data for pathogen inactivation/reduction technologies are also reported, where budget impact rather than cost-effectiveness may currently be the most important impediment to broader adoption in many jurisdictions. Overall, interventions for microbial threats in the blood supply are less cost-effective (have higher cost per effectiveness achieved) than many other areas of healthcare because of the expectation for a high level of safety and prevention of transmission by transfusion.