{"doi":"10.1111/vox.70144","title":"Cost‐effectiveness of a hypothetical assay to evaluate stored blood quality prior to transfusion","abstract":"BACKGROUND AND OBJECTIVES: Unsuccessful red blood cell (RBC) transfusion, necessitating unscheduled repeat transfusion, is common and costly. Several technologies have been developed to assess stored blood quality, but the potential cost-effectiveness of pretransfusion testing versus no testing to prevent unscheduled re-transfusion is unknown. MATERIALS AND METHODS: Projected benefits and costs of implementing a hypothetical pretransfusion assay were evaluated using Markov models with 10,000 Monte Carlo simulations. Chronic RBC transfusions were modelled at 1-month intervals over a 1-year time horizon, for 'simple' and 'complicated' (requiring antigen matching) cohorts. Model inputs included transfusion costs and quality-of-life weights. Cost-effectiveness was defined as incremental net monetary benefit (INMB) > 0, assuming willingness to pay <$50,000 per quality-adjusted life year (QALY). RESULTS: The Centers for Medicare and Medicaid Services reimbursement for a single-unit RBC transfusion was $970 ($853-$1313) and $2377 ($2057-$3317), respectively, for the simple and complicated cohorts. The hypothetical assay was priced at $100 ($38-$163) and was assumed to lower unscheduled re-transfusions by 30%, from 64% to 45% (40%-50%). Pretransfusion testing yielded 0.02 higher QALY (95% prediction interval [PI]: 0.01-0.02); annual per-patient cost savings of $269 (95% PI: $263-$276) and $3651 (95% PI: $3633-$3669), respectively, for the simple and complicated cohorts; and INMB of $1083 (95% PI: $985-$1180) and $4347 (95% PI: $4250-$4443). CONCLUSION: Assessment of RBC quality by a hypothetical test prior to transfusion may reduce the incidence and associated costs of unscheduled re-transfusions and, with modelled assumptions, could be especially cost-effective for patients with complicated chronic transfusion requirements.","journal":"Vox Sanguinis","year":2025,"id":537094,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9601,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1201469,"name":"Tara Templin","orcid":"0000-0003-4984-6472","position":1,"is_corresponding":false},{"id":321172,"name":"Nareg H. Roubinian","orcid":"0000-0002-1063-6155","position":2,"is_corresponding":false},{"id":447270,"name":"Matthew S. Karafin","orcid":"0000-0001-7533-6842","position":3,"is_corresponding":false},{"id":323654,"name":"Melissa C. Caughey","orcid":"0000-0001-8433-5147","position":0,"is_corresponding":true}],"reference_count":20,"raw_metadata":null,"created_at":"2026-07-19T02:52:09.056872Z","pmid":"41192946","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}