Center for Medical Technology Assessment, Department of Clinical and Experimental Medicine, Linköping University, Sweden.
Transfusion. 2011 Feb;51(2):421-9. doi: 10.1111/j.1537-2995.2010.02877.x. Epub 2010 Sep 16.
The purpose of this study was to estimate the cost-effectiveness of using individual-donor nucleic acid testing (ID-NAT) in addition to serologic tests compared with the sole use of serologic tests for the identification of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors in Sweden.
The two strategies analyzed were serologic tests and ID-NAT plus serologic tests. A health-economic model was used to estimate the lifetime costs and effects. The effects were measured as infections avoided and quality-adjusted life-years (QALYs) gained. A societal perspective was used.
The largest number of viral transmissions occurred with serologic testing only. However, the risks for viral transmissions were very low with both strategies. The total cost was mainly influenced by the cost of the test carried out. The cost of using ID-NAT plus serologic tests compared to serologic tests alone was estimated at Swedish Krona (SEK) 101 million (USD 12.7 million) per avoided viral transmission. The cost per QALY gained was SEK 22 million (USD 2.7 million).
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.
本研究旨在评估与单独使用血清学检测相比，在瑞典献血者中使用个体供者核酸检测（ID-NAT）结合血清学检测来识别乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）的成本效益。
分析的两种策略是血清学检测和 ID-NAT 加血清学检测。使用健康经济学模型来估计终生成本和效果。效果以避免的感染和质量调整生命年（QALY）来衡量。采用社会视角。
仅使用血清学检测时发生的病毒传播数量最多。然而，两种策略的病毒传播风险都非常低。总成本主要受所进行的检测成本影响。与单独使用血清学检测相比，使用 ID-NAT 加血清学检测的成本估计为每避免一次病毒传播 1.01 亿瑞典克朗（1270 万美元）。每获得一个 QALY 的成本为 2200 万瑞典克朗（270 万美元）。
在瑞典，对献血者进行 HBV、HCV 和 HIV 的 ID-NAT 检测具有成本效益，其成本效益比远远超过通常认为的成本效益。主要原因是，在目前的方法下，瑞典的病毒传播风险非常低。
