Original article

Blood Transfusion - 6 2018 (November-December)

Budget impact of implementing platelet pathogen reduction into the Italian blood transfusion system

Authors

Key words: platelet transfusion, pathogen reduction technology, transfusion risks
Publication Date: 2018-09-03

Abstract

Background. Despite improvements in blood donor selection and screening procedures, transfusion recipients can still develop complications related to infections by known and emerging pathogens. Pathogen reduction technologies (PRT) have been developed to reduce such risks. The present study, developed whithin a wider health technology assessment (HTA) process, was undertaken to estimate the costs of the continuing increase in the use of platelet PRT in Italy.
Materials and methods. A multidisciplinary team was established to perform the HTA and conduct a budget impact analysis. Quantitative data on platelet use were derived from the 2015 national blood transfusion report and from the Italian Platelets Transfusion Assessment Study (IPTAS). The current national fee of 60 Euro per platelet PRT procedure was used to quantify the costs to the Italian National Health Service (INHS). The analysis adopts a 3-year time-frame. In order to identify the impact on budget we compared a scenario representing an increased use of PRT platelets over time with a control scenario in which standard platelets are used.
Results. Progressive implementation of PRT for 20%, 40% and 66% of annual adult platelet doses could generate an increase in annual costs for the INHS amounting to approximately 7, 14 and 23 million Euros, respectively. Use of kits and devices suitable for the treatment of multiple adult platelet doses in one PRT procedure could lower costs.
Discussion. In order to fully evaluate the societal perspective of implementing platelet PRT, the increase in costs must be balanced against the expected benefits (prevention of transfusion-transmissible infections, white cell inactivation, extension of platelet storage, discontinuation of pathogen detection testing). Further studies based on actual numbers of platelet transfusion complications and their societal cost at a local level are needed to see the full cost to benefit ratio of platelet PRT implementation in Italy, and to promote equal treatment for all citizens.

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Authors

Americo Cicchetti - Graduate School of Health Economics and Management (ALTEMS) - Università Cattolica del Sacro Cuore, Rome

Silvia Coretti - Graduate School of Health Economics and Management (ALTEMS) - Università Cattolica del Sacro Cuore, Rome

Francesco Sacco - Graduate School of Health Economics and Management (ALTEMS) - Università Cattolica del Sacro Cuore, Rome

Paolo Rebulla - Blood Transfusion Service, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan

Alessandra Fiore - Graduate School of Health Economics and Management (ALTEMS) - Università Cattolica del Sacro Cuore, Rome

Filippo Rumi - Graduate School of Health Economics and Management (ALTEMS) - Università Cattolica del Sacro Cuore, Rome

Rossella Di Bidino - Health Technology Assessment Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome

Luz I. Urbina - Health Technology Assessment Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome

Pietro Refolo - Institute of Bioethics and Medical Humanities, Fondazione Policlinico "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome

Daria Sacchini - Institute of Bioethics and Medical Humanities, Fondazione Policlinico "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome

Antonio G. Spagnolo - Institute of Bioethics and Medical Humanities, Fondazione Policlinico "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome

Emanuela Midolo - Italian National Blood Centre, National Institute of Health, Rome, Italy

Giuseppe Marano - Italian National Blood Centre, National Institute of Health, Rome, Italy

Blandina Farina - Italian National Blood Centre, National Institute of Health, Rome, Italy

Ilaria Pati - Italian National Blood Centre, National Institute of Health, Rome, Italy

Eva Veropalumbo - Italian National Blood Centre, National Institute of Health, Rome, Italy

Simonetta Pupella - Italian National Blood Centre, National Institute of Health, Rome, Italy

Giancarlo M. Liumbruno - Italian National Blood Centre, National Institute of Health, Rome, Italy

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