van Hulst M, de Wolf J T M, Staginnus U, Ruitenberg E J, Postma M J
Department of Social Pharmacy, Groningen University Institute for Drug Exploration/University of Groningen Research Institute of Pharmacy (GUIDE/GRIP), Antonius Deusinglaan 1, 9713 AV Groningen, the Netherlands.
Vox Sang. 2002 Aug;83(2):146-55. doi: 10.1046/j.1423-0410.2002.00198.x.
Pharmaco-economics provides a standardized methodology for valid comparisons of interventions in different fields of health care. The role of pharmaco-economics in the safety of blood and blood products has, however, been very limited to date. This review discusses the pharmaco-economic evaluations of strategies to enhance blood product safety that have been published in the scientific literature.
We reviewed pharmaco-economic methodology with special reference to cost-effectiveness analysis. We searched the literature for cost-effectiveness in blood product safety.
Net costs per quality adjusted life-year (QALY) gained varied from cost-saving for human immunodeficiency virus (HIV)- and hepatitis C virus (HCV) antibody screening and leucoreduction to several million US dollars per QALY gained for solvent-detergent treatment of plasma, nucleic acid amplification testing and HIV p24 antigen testing.
To date the safety of blood transfusion has been largely determined by available technology, irrespective of pharmaco-economics. Net costs up to several million US dollars per QALY gained were found for interventions implemented.
药物经济学为医疗卫生不同领域的干预措施进行有效比较提供了标准化方法。然而,迄今为止,药物经济学在血液及血液制品安全性方面的作用非常有限。本综述讨论了科学文献中已发表的关于提高血液制品安全性策略的药物经济学评价。
我们特别参照成本效益分析对药物经济学方法进行了综述。我们在文献中搜索血液制品安全性方面的成本效益情况。
每获得一个质量调整生命年(QALY)的净成本差异很大,从因人类免疫缺陷病毒(HIV)和丙型肝炎病毒(HCV)抗体筛查及白细胞去除术而节省成本,到因血浆的溶剂去污剂处理、核酸扩增检测和HIV p24抗原检测每获得一个QALY需花费数百万美元不等。
迄今为止输血安全性很大程度上由现有技术决定,而与药物经济学无关。已实施的干预措施每获得一个QALY的净成本高达数百万美元。