EFFICIENCY OF A PROPOSED BLOOD DONOR SCREENING STRATEGY

BACKGROUND – Currently, pre-donation, capillary hemoglobin screening is the only measure of blood donor iron status in the Dutch blood donation practice. Ferritin measurements and targeted hemoglobin screening have been previously proposed as potential screening strategy advancements. Based on these advancements, a comprehensive new screening strategy was proposed. This study aimed to assess differences in efficiency between this new screening strategy, and the current, Dutch screening strategy standard. METHODS – Differences in efficiency were assessed determining the incremental cost-effectiveness ratio of the proposed strategy over the current Dutch strategy. Donors approved for donation were considered screening strategy benefits. Screening strategy costs and benefits were evaluated fitting the screening strategies to a Markov model. Parameter values were based on a 2012 to 2014 dataset of Dutch blood donations, and relevant literature. A donation facility perspective was adopted. RESULTS – At a five-year time-horizon, compared to the current strategy, the proposed screening strategy resulted in 33% higher female screening costs, and a 9% decrease in the number of female donors approved for donation. At the same time-horizon, among male donors, the proposed strategy resulted in a 21% decrease of screening costs, and an amount of approved donors equal to the current strategy. CONCLUSION – Compared to the current Dutch screening strategy, the screening strategy as proposed would result in increased screening costs and decreased screening benefits among female donors, and decreased screening costs and increased screening benefits among male donors. The current Dutch donor population gender composition would result in female proposed strategy disadvantages outweighing male proposed strategy advantages. Future research might complement results derived by this study with quantified proposed strategy effects on donor health.