Rosenshein M S, Farewell V T, Price T H, Larson E B, Dale D C
N Engl J Med. 1980 May 8;302(19):1058-62. doi: 10.1056/NEJM198005083021904.
We analyzed the cost effectiveness of leukocyte transfusion in preventing death from infection during intensive chemotherapy for acute leukemia. Effectiveness was estimated with an odds-ratio analysis based on published results of controlled studies of therapeutic and prophylactic leukocyte transfusion. Cost estimates were based on blood-bank charges throughout the country. Calculations of effectiveness suggest that leukocyte transfusion might prevent 50 to 75% of early deaths from infection. Therapeutic transfusion would add approximately 10.9% to the hospital bill of the average bill of the average leukemic patient and cost $17.7 million annually nationwide. Prophylactic transfusion would add 35.2% to the hospital bill and cost $57.8 million annually. Mean cost-effectiveness ratios were $14,982 per life-year for therapeutic transfusion and $35,020 to $50,029 per life-year for prophylactic transfusion. The cost per additional life-year achieved with prophylactic rather than therapeutic leukocyte transfusion was $85,291. These data suggest that leukocyte transfusion is an extremely expensive technologic procedure.
我们分析了白细胞输注在预防急性白血病强化化疗期间因感染导致死亡方面的成本效益。根据已发表的治疗性和预防性白细胞输注对照研究结果，通过比值比分析来评估疗效。成本估计基于全国血库收费情况。疗效计算表明，白细胞输注可能预防50%至75%的早期感染死亡。治疗性输注将使白血病患者平均住院费用增加约10.9%，全国每年花费1770万美元。预防性输注将使住院费用增加35.2%，每年花费5780万美元。治疗性输注的平均成本效益比为每生命年14982美元，预防性输注为每生命年35020至50029美元。与治疗性白细胞输注相比，预防性白细胞输注每多获得一个生命年的成本为85291美元。这些数据表明，白细胞输注是一种极其昂贵的技术程序。
