COST-EFFECTIVENESS OF SCREENING BLOOD-DONORS FOR HEPATITIS-C AND NON-A, NON-B, NON-C HEPATITIS

The current approach to screening for hepatitis C and non-A, non-B, no n-C hepatitis in French blood transfusion centers involves a combinati on of a transaminase assay and tests for antibodies to hepatitis B cor e antigen (anti-HBc) and antibodies to hepatitis C virus (anti-HCV), A decision-analysis model was used to assess the cost-effectiveness rat io of this approach compared to the former approach, which included on ly transaminase and anti-HBc screening, Cost data were collected by a questionnaire sent to 26 centers throughout France, The average costs of diagnostic kits, equipment, staff, and administration were calculat ed, Estimates of prevalence and sensitivity values came from the medic al literature, The cost-effectiveness ratio was expressed in French fr ancs per infected donor detected. A sensitivity analysis of the variab les in the model was performed to estimate the validity of the cost-ef fectiveness ratio, For 100,000 donations the incremental cost of the c urrent approach reached FrF 2,566,111 (about US $ 500,000), with a mar ginal effectiveness of 180 donations detected. The sensitivity analysi s showed the effect of prevalence on the incremental cost-effectivenes s ratio. Transfusion centers may change their screening approach in ar eas of high or low prevalence of hepatitis C in France.