Blood safety and resource allocation: economic analyses of donated blood safety initiatives

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Blood safety and resource allocation: economic analyses of donated blood safety initiatives

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Title: Blood safety and resource allocation: economic analyses of donated blood safety initiatives
Author: Custer, Brian Scott
Abstract: Risk management at any cost has become the apparent policy of blood banks and regulators because of transfusion-transmitted HIV and hepatitis. However, blood bank opinion leaders suggest economic analyses of new interventions are increasingly important for choosing between competing interventions. In this document we explore these issues and describe a new model to assess blood policy decisions. First, we provide a systematic review of blood supply policy evaluations and discuss improvements that can increase the usefulness of economic evaluation for decision makers. Researchers should: (1) provide more detail on cost parameters and methods used to obtain them; (2) adopt a clear analysis perspective relevant to decision makers that captures all important costs and consequences; (3) at minimum, conduct one-way sensitivity analyses; and (4) place greater reliance on graphical results presentation. Next, we describe a new model developed to evaluate factors that influence the safety, sufficiency, and cost of producing a blood supply. The model was developed using data from Blood Centers of the Pacific, San Francisco. The model is a cohort simulation that tracks blood donation beginning with the population of persons presenting for donation and ending with units of blood cleared for release to health care providers. We used the blood supply policy model to assess the impact of the U.S. Food and Drug Administration's expanded donor deferral criteria for European travel due to possible exposure to variant Creutzfeldt-Jakob disease. Expanded European travel deferral will lead to the permanent deferral of 3,271 donors (95% Confidence Range, 2,600--3,973 donors) reducing the supply of blood by 3,141 units out of an approximate 94,000 unit annual supply produced by this blood bank. The cost of each blood unit increases by $0.53 from the blood bank perspective and by $1.22 from the societal perspective. 2.8% of blood units that would have been available before the policy will be lost from the supply unless recruitment efforts are enhanced to bring in new donors and increase the frequency of repeat donation. This evaluation and other economic analyses provide a valuable approach for assessing the trade-off between safety and sufficiency for the blood supply.
Description: Thesis (Ph. D.)--University of Washington, 2003

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