Table 4.
Cost-effectiveness analysis of 103,955 donors* in Chinese Shenzhen Blood Center.
| Screening strategy | |||
|---|---|---|---|
| HBsAg+anti-HBc | HBsAg+ MP6 NAT | HBsAg+ MP6+ anti-HBc in MP+/ID− | |
| Cost (RMB) | 1,247,460 | 1,435,748 | 1,436,252 |
| CHBa | 249 | 249 | 249 |
| OBIb | 194 | 56 | 73 |
| WP acute infection | 0 | 1.8 | 1.8 |
| Predicted transfusion transmitted HBV casesc | 272.8 | 224.8 | 231 |
| Benefit (RMB) | 114,576,000 | 94,416,000 | 97,020,000 |
| Benefit/cost | 91.8 | 65.8 | 67.6 |
*After screening 103,955 donors by ELISA, 103,356 seronegative blood samples (17,226 MP6 pools) were enrolled in this study.
HBsAg DiaSorin (Italy) ELISA: 10 RMB/test; WanTai anti-HBc ELISA: 2 RMB/test. 1$=6.9RMB.
MP6: Roche MPX2.0 NAT for HBV DNA/HCV RNA/HIV RNA/ID format: 68 RMB/test, screening for HBV using MP6: 23 RMB/pool (17,226 pools).
CHB: the rate of HBsAg ELISA+ was 0.3% in Shenzhen blood donors’ population, of which 80% were NAT+, and confirmed HBsAg+/DNA+ as CHB.
OBI: according to previous study (12), we predicted the OBI with anti-HBc were (113+162×72.6%) × 103955/123280 = 194. The percentage of OBI with anti-HBc in NAT+ was 72.6% (45).
Transmissions rate of OBI by blood transfusion = 2/11 (18.2%) (11 donor-recipient pairs cause two HBV infections (8). Transmissions rate of WP acute HBV infection by blood transfusion = 63% (23). Transmissions rate of CHB by blood transfusion = 40.6% (median of OBI and WP, no reference data).
C = (a×0.406+b×0.182+c×0.63) × 2 (a donation produces two units washed red blood cells and 200 ml frozen plasma, at least transfused two recipients).
Benefit (RMB)= Predicted transfusion transmitted HBV cases×420,000 (46), preventing one case of HBV infection can recover the medical cost of 420,000 RMB.