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SUMMARY: Cost-effectiveness of leucodepleted erythrocytes (LD) over buffy-coat-depleted packed cells (PC) is estimated from the primary dataset of a recently reported randomized clinical trial involving valve surgery ( /-CABG) patients. Data on the patient level of 474 adult patients who were randomized double-blind to LD or PC were used in order to calculate the healthcare costs and longevity per patient. The incremental cost-effectiveness ratio (ICER) in net costs per life-year gained was established from the healthcare perspective. Bootstrapping and cost-effectiveness acceptability curves were used in order to determine the confidence interval (CI) of the ICER. The longevity of patients in the PC and LD group was 10[middle dot]6 and 11[middle dot]4 years, respectively. Relative to PC, LD yielded an estimated 0[middle dot]8 (95% CI = -0[middle dot]27 to 1[middle dot]84) life-year in the baseline. Adjusted for age and sex differences, health gains for LD are 0[middle dot]4 life-year gained (95% CI = -0[middle dot]67 to 1[middle dot]44). Healthcare costs per patient averaged US$ 10163 per patient in the PC group and US$ 9949 in the LD group. Average cost-savings were US$ 214 (95% CI = -1536 to 1964) per patient. Acceptability curves constructed from bootstrap simulations showed a probability of being cost-saving of 59% for universal leucodepletion from the healthcare perspective. The probability of adopting leucodepletion regardless of the costs reaches 92[middle dot]7%. LD in patients receiving four or more transfusions showed the highest cost-savings and health gains. Leucodepletion of erythrocytes is a cost-saving strategy in cardiac valve ( /-CABG) patients. However, probablistic analysis failed to show a significant difference with buffy-coat-depleted PC.

Copyright (C) 2005 Blackwell Publishing Ltd.