Abstract

To assess the cost and effectiveness of adding a system of polymerase chain reaction (PCR) testing to the current enzyme-linked immunosorbent assay (ELISA) screening for hepatitis C virus (HCV) in blood donations. We performed a cost-effectiveness analysis comparing three HCV screening strategies in French blood donors: detection of antibodies against HCV by an ELISA on blood donations (the current policy) vs. ELISA and PCR either on each blood donation or on blood pools. We combined national surveillance data on HCV antibody-positive blood donors with a literature review in a Markov model for natural history of HCV disease and its treatment. PCR testing performed in parallel with ELISA will potentially add less than 1 year of life for all French recipients compared to ELISA screening alone. The incremental costs per life year saved were, respectively, epsilon84.6 million with ELISA and PCR testing of blood pools, and epsilon891.1 million with testing of individual blood donations. PCR testing performed in parallel with antibody screening, either on pools or on single donations is not currently a cost-effective option for the detection of HCV RNA virus in blood donors.

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