Table 1.
Model Input Parameters (Base-Case Values and Ranges for Sensitivity Analysis)
| Input Parameter | Base-Case Value (Range) | Source |
|---|---|---|
| Initial Testing | ||
| Cost: ABO Type | $7.71 (5.78, 9.64) | 22 |
| Cost: Rh Type | $7.71 (5.78, 9.64) | 22 |
| Cost: Antibody Screen | $14.95 (11.21, 18.69) | 22 |
| Cost: Antibody Identification (for patients with positive screen only) | $24.77 (18.58, 30.96) | 22 |
| Cost: Initial RBC Antigen Phenotyping (14-antigen)a | $364 (273, 455) | 24 |
| Pre-transfusion Testing/Matching | ||
| Cost: Leukoreduced RBC unit | $198.87 (149.15, 248.59) | 21 |
| Cost: ABO Type | $7.71 (5.78, 9.64) | 22 |
| Cost: Rh Type | $7.71 (5.78, 9.64) | 22 |
| Cost: Antibody Screen | $14.95 (11.21, 18.69) | 22 |
| Cost: Antibody Identification (for patients with positive screen only) | $24.77 (18.58, 30.96) | 22 |
| Cost: Direct Antiglobulin Test (for patients with positive screen only) | $7.71 (5.78, 9.64) | 22 |
| Cost: Elution (for patients with positive DAT only) | $24.77 (18.58, 30.96) | 22 |
| Cost: Adsorption Study (for patients with positive screen indicating AutoAB only)b | $24.77 (18.58, 30.96) | 22 |
| Cost: Electronic Compatibility Testing (for patients with negative screen) | $14.95 (11.21, 18.69) | 22 |
| Cost: AHG Compatibility Testing (for patients with positive screen) | $24.77 (18.58, 30.96) | 22 |
| Cost: Negative Antigens (per antigen negative, per unit) | $80 (60, 100) | 24 |
| Post-transfusion Testing | ||
| Cost: DHTR Hospitalization | $1392.09 (1044.07, 1740.11) | 23 |
| Cost: Antibody Screen | $14.95 (11.21,18.69) | 22 |
| Cost: Antibody Identification (for patients with positive screen only) | $24.77 (18.58,30.96) | 22 |
| Cost: Direct Antiglobulin Test (for patients with positive screen only) | $7.71 (5.78,9.64) | 22 |
| Cost: Elution (for patients with positive DAT only) | $24.77 (18.58,30.96) | 22 |
| Cost: Adsorption Study (for patients with positive screen indicating AutoAB only) | $24.77 (18.58,30.96) | 22 |
| Alloimmunization Rate | ||
| Portion of Patients Experiencing Alloimmunization Risk (portion of “responders”) | 30% (25, 35) | 5,8–10 |
| Matching ABO, D Only (among ”responders”, per 100 units transfused) | 3.27 (1–5) | 14,28 |
| Percent Reduction in Alloimmunization Risk from Limited Matching (ABO, D, C, E, K) | 85% (75–95) | 13,28,29 |
| Percent Reduction in Alloimmunization Risk from Extensive Matching | 99% (90–100) | Assumed 30 |
| Portion of Patients with Positive DAT (among those with positive screen) | 25% (15–35) | 6 |
| DHTR | ||
| Portion of alloimmunization events leading to DHTRs (Pediatric/Adult) | 17.3/3.4 (15–20/1–5) | 7 |
| Patient/Background Characteristics | ||
| Portion of initial cohort of patients with transfusion and AlloAb history | Varies by age | 27 |
| Annual SCD Incident Patient Population (National)c | 1674 (1256, 2093) | 3,8,34 |
| Initial Prevalent SCD Patient Population | 85000 (72000, 98000) | 3 |
| Portion of Pediatric SCD Patients Undergoing Chronic Transfusion Therapy | 4.67% (2, 6) | 19 |
| Portion of SCD Patients Undergoing Chronic Transfusion Therapy (over lifetime) | 10% (5, 15) | Assumed |
| Transfusion Sessions per Year for Chronic Therapy | 12 (6–20) | Assumed |
| Units per Simple Transfusion Session (Pediatric Patients) | 1 (1–3) | Assumed |
| Units per Exchange Transfusion Session (Pediatric Patients) | 8 (6–12) | Assumed |
| Portion of Chronically Transfused Pediatric Patients Undergoing Exchange Transfusion | 64.3% (40–80) | 19 |
| Units per Simple Transfusion Session (Adult Patients) | 2 (2–4) | Assumed |
| Units per Exchange Transfusion Session (Adult Patients) | 10 (8–14) | Assumed |
| Portion of Chronically Transfused Adult Patients Undergoing Simple Transfusion | 50% (40–60) | 20 |
| Age and Sex-specific Mortality Rate | Varies by age, sex | 34 |
Note: All costs are expressed in 2012 US$.
a
Assumes $26 per antigen as reported.
b
Cost estimate for adsorption studies was not reported in the original source, but it was assumed that the reimbursement rate for adsorption would be comparable to rates for elution.
c
Incidence estimated from birth cohort SCD prevalence by race and estimates of birth cohort populations by race.