Assessment of the Economic Value of the Intercept Blood System for Platelets in Belgium.

Objectives: Despite transfusion safety measures, a residual risk of infection remains. New emerging pathogens continue to threaten blood safety, requiring novel approaches to prevent transmission as from the time of emergence. INTERCEPT Blood System for platelets (IBSP) inactivates different types of pathogens including viruses, bacteria and parasites, aiming at eliminating the residual risk of screened infections, the risk of other existing pathogens and the risk of transmitting emerging pathogens. The objective was to evaluate the potential incremental cost-effectiveness ratio (ICER) associated with implementing IBSP in Belgium.

Methods: A decision model compares a “world with IBSP” to a “world without IBSP”. It calculates lifetime costs and “quality adjusted life years” (QALYs) following platelet transfusion in patients with different oncological and surgical indications, taking into account disease specific life expectancy and the potential impact of transfusion transmitted infections. Transfusion safety data were obtained from Belgian Red Cross, costs from Belgian health insurance. The health economic consequences of HIV, HCV and HBV transmission were modelled on the basis of clinical and economic literature. In addition a HCV-like emerging pathogen was simulated at different risk levels based on current and historical hepatitis, HIV and West Nile Virus transmission data. Different scenarios for additional benefits (elimination of current safety measures) were considered.

Results: A wide range of ICERs was observed, highly sensitive to the risk of emerging pathogen transmission, underlying disease and age. In the most conservative scenario with emerging risk of 1/100,000 and no additional benefits, the ICER ranged from 3,355,308€/QALY to 165,051€/QALY. The mean threshold of emerging infection risk for dominance of IBS ranged from 1/1,074transfusions to 1/2,277transfusions depending on additional benefits.

Conclusion: Considering the high value society places on prevention of accidental injury, and the ICER of recent implementations in transfusion medicine (NAT testing: up to €2.3 million/lifeyear), IBSP can be considered cost-effective and even a dominant strategy taking into account the potential risk of emergence of a new pathogen in the future.