In 2016, the United States began mandated screening of individual donations for the Zika Virus (ZIKV) using nucleic acid testing (NAT). More recently, the U.S. FDA approved pooling donated blood samples to screen for ZIKV. Researchers at the 2018 Annual AABB Meeting presented a microsimulation model designed to estimate the cost-effectiveness of individual donor-NAT ZIKV screening, mini pool-NAT screening, and no screening. Based on a willingness-to-pay threshold of $1 million per quality-adjusted life year gained (QALY), mini-pooling or individual NAT screening was cost effective only when the ZIKV rate was greater than 1.3 or 7.7 positive donated units per 1000 collected, respectively. During the 2016 epidemic, the rate of ZIKA positive donations did not reach these thresholds. The cost-effectiveness of screening should be considered along with other risks when determining screening policies.
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