Octaplas compared with fresh frozen plasma to reduce the risk of transmitting lipid-enveloped viruses: an economic analysis and budget impact analysis

Membe S, Cimon K, Tinmouth A, Normandin S
Record ID 32008000110
English, French
Authors' objectives:

"This study investigates the cost-effectiveness position of Octaplas against standard FFP, and its budgetary impact to the health care system. Specifically, the study answers the following research questions: 1) What is the cost-effectiveness of Octaplas versus standard frozen plasma (FP)/FFP regarding safety across the following indications: liver disease and transplantation, thrombotic thrombocytopenic purpura (TTP), cardiovascular surgery, and coagulation disorders? 2) What is the budget impact if Octaplas: (i) replaced all FFP in Canada (excluding Quebec), or (ii) replaced FFP cryosupernatant plasma (CSP) for treatment of TTP in Canada?" (executive summary)

Authors' results and conclusions: The results of the cost-utility analysis (CUA) showed that FP/FFP is less costly and more effective (dominates) compared to Octaplas. The most important driver of cost-effectiveness is HBV incident rates, per unit cost of Octaplas, and incident rates of TRALI. The results of the CEA showed that Octaplas produced a discounted C/LYS between CAD36,196 and CAD47,434 for plasma recipients between 25 and 35 years of age. For recipients between 35 and 55 years of age, C/LYS of Octaplas ranged from CAD47,434 to CAD77,208, whereas for recipients between 55 and 65 years of age, Octaplas produced C/LYS between CAD77,208 and CAD94,849. C/LYS was found to range from CAD94,849 to CAD103,743 for plasma transfusion recipients between 65 and 75 years of age. C/LYS was most responsive to short-term hospital mortality rate, recipient's age, and incremental cost of Octaplas.
Authors' recommendations: Octaplas produces less safety benefits at higher cost than standard FP/FFP. Cost-ineffectiveness of Octaplas results from low transfusion-related risks for FP/FFP, engineered by advances in the safety measures of blood transfusion, such as testing, donor screening, and deferral. Also, due to the average age (65 years) of plasma recipients and poor short-term prognosis of recipients, projected benefits of Octaplas are reduced. From the net-benefit point of view, switching to Octaplas provides absolute benefits to the health care system, as it increases the volume of muchneeded IVIg and albumin. However, overall, in relative terms, the health care system incurs a net loss, as it could purchase the added volume of IVIg and albumin at lower total cost from its current suppliers.
Authors' methods: Systematic review
Details
Project Status: Completed
Year Published: 2008
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Plasma
  • Viruses
Contact
Organisation Name: Canadian Agency for Drugs and Technologies in Health
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name: requests@cadth.ca
Contact Email: requests@cadth.ca
Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)
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