Cost Effectiveness of Different Platelet Preparation, Storage, Selection and Dosing Methods in Platelet Transfusion: A Systematic Review

Jorien Laermans (), Hans Van Remoortel, Hans Scheers, Bert Avau, Jørgen Georgsen, Susan Nahirniak, Nadine Shehata, Simon J. Stanworth, Emmy De Buck, Veerle Compernolle and Philippe Vandekerckhove
Additional contact information
Jorien Laermans: Belgian Red Cross
Hans Van Remoortel: Belgian Red Cross
Hans Scheers: Belgian Red Cross
Bert Avau: Belgian Red Cross
Jørgen Georgsen: Odense University Hospital
Susan Nahirniak: University of Alberta
Nadine Shehata: University of Toronto
Simon J. Stanworth: NHS Blood and Transplant
Emmy De Buck: Belgian Red Cross
Veerle Compernolle: Belgian Red Cross
Philippe Vandekerckhove: KU Leuven

PharmacoEconomics - Open, 2023, vol. 7, issue 5, No 1, 679-708

Abstract: Abstract Background and Objective Evidence-based guidelines on platelet transfusion therapy assist clinicians to optimize patient care, but currently do not take into account costs associated with different methods used during the preparation, storage, selection and dosing of platelets for transfusion. This systematic review aimed to summarize the available literature regarding the cost effectiveness (CE) of these methods. Methods Eight databases and registries, as well as 58 grey literature sources, were searched up to 29 October 2021 for full economic evaluations comparing the CE of methods for preparation, storage, selection and dosing of allogeneic platelets intended for transfusion in adults. Incremental CE ratios, expressed as standardized cost (in 2022 EUR) per quality-adjusted life-year (QALY) or per health outcome, were synthesized narratively. Studies were critically appraised using the Philips checklist. Results Fifteen full economic evaluations were identified. Eight investigated the costs and health consequences (transfusion-related events, bacterial and viral infections or illnesses) of pathogen reduction. The estimated incremental cost per QALY varied widely from EUR 259,614 to EUR 36,688,323. For other methods, such as pathogen testing/culturing, use of apheresis instead of whole blood-derived platelets, and storage in platelet additive solution, evidence was sparse. Overall, the quality and applicability of the included studies was limited. Conclusions Our findings are of interest to decision makers who consider implementing pathogen reduction. For other preparation, storage, selection and dosing methods in platelet transfusion, CE remains unclear due to insufficient and outdated evaluations. Future high-quality research is needed to expand the evidence base and increase our confidence in the findings.

Date: 2023
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DOI: 10.1007/s41669-023-00427-w

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