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. Author manuscript; available in PMC: 2015 Jan 1.
Published in final edited form as: Transfusion. 2013 May 21;54(1):86–97. doi: 10.1111/trf.12250

Table 2.

Base-Case Results: Cohort of Initially Transfusion-Naive Chronically Transfused Sickle Cell Patients

Strategy
History-Based Matching Prospective Matching
Time Period 1: Limited 2: Extended 3: Limited 4: Extended
10 years
 Total Cost per Transfused Unit: All Patients ($)a 252.33 301.82 367.50 581.47
  Cost of Testing 19.53 19.50 18.45 16.99
  Cost of Units 232.47 282.19 348.79 564.47
  Cost of Complications 0.34 0.12 0.25 0.02
 Total Cost per Transfused Unit: Alloimmunized Patients Only ($)b 397.45 564.57 371.43 580.51
  Cost of Testing 25.96 25.87 21.59 14.76
  Cost of Units 370.34 538.28 348.91 565.48
  Cost of Complications 1.16 0.41 0.93 0.27
 Entire SCD Cohort (over 10 year period)c
  Total Cost (millions, $) 1665.65 2014.31 2431.21 3879.20
   Net Change (Extended vs. Limited) 348.66 1447.99
   Net Change (Prospective vs. History-Based) 765.56 1864.89
  Alloimmunization Events 11058 3081 8986 657
   Net Change (Extended vs. Limited) −7977 −8329
   Net Change (Prospective vs. History-Based) −2072 −2424
 Cost per Alloimmunization Event Avoided (thousands, $)d
  Extended vs. Limited 43.71 173.84
  Prospective vs. History-Based 369.48 769.28
20 years
 Total Cost per Transfused Unit: All Patients ($)a 220.37 264.16 320.70 506.63
  Cost of Testing 15.99 15.99 15.40 13.93
  Cost of Units 204.09 248.11 305.06 492.69
  Cost of Complications 0.28 0.06 0.24 0.02
 Total Cost per Transfused Unit: Alloimmunized Patients Only ($)b 351.73 500.60 325.51 504.45
  Cost of Testing 21.70 21.67 19.60 12.77
  Cost of Units 329.06 478.72 305.06 491.55
  Cost of Complications 0.97 0.22 0.85 0.14
 Entire SCD Cohort (over 20 year period)c
  Total Cost (millions, $) 2928.62 3533.02 4274.97 6796.30
   Net Change (Extended vs. Limited) 604.41 2521.33
   Net Change (Prospective vs. History-Based) 1346.36 3263.28
  Alloimmunization Events 17887 3475 15786 1083
   Net Change (Extended vs. Limited) −14412 −14703
   Net Change (Prospective vs. History-Based) −2101 −2391
 Cost per Alloimmunization Event Avoided (thousands, $)d
  Extended vs. Limited 41.94 171.49
  Prospective vs. History-Based 640.79 1364.56
a

Total cost per transfused unit reflects the average expected cost per unit transfused across all chronically transfused patients over a period of time (10 or 20 years). Cohort only includes patients without a history of transfusion/alloimmunization.

b

Total cost per transfused unit reflects the average cost per unit transfused across all alloimmunized patients in the cohort.

c

Outcomes for an entire cohort of chronically transfused SCD patients. Assumes a population of 85,000 SCD patients, of which 10% are chronically transfused. Net change outcomes calculated as Extended-Limited or Prospective – History-Based.

d

Positive outcomes for cost per alloimmunization event avoided indicate additional required expenditure to avert a single alloimmunization event. Negative outcomes reflect a decrease in costs associated with either extended or prospective matching.