3.3 Results

The estimated number of adverse events in a year without PI was 24,705 (21,115 – 37,904). PI reduced the number of adverse events by 19,502 (13,187 – 27,477) to 5,204 (5,179 – 14,375) per year. Most of the averted adverse events were sepsis (51%) and malaria (32%) infections (Table 3.2).

The estimated net present cost per adverse event ranged from $2.70 ($1.36 – $4.77) for syphilis to $1,617.45 ($1,149.76 – $2,269.04) for HBV. Because most HIV, HCV and HBV infections would be subclinical for the first year, over 90% of healthcare spending associated with these three adverse events is estimated to occur in later years (Supplemental Table 8.4). The total net present healthcare costs due to adverse events was $9,910,064 ($6,362,546 – $14,811,006) without PI and $815,046 ($705,824 – $1,716,051) with PI. Of the adverse events evaluated, sepsis infection had only the fourth highest per-case cost at $694.80 ($546.07 – $882.25) but represented the majority of healthcare spending due to adverse events without PI (73%) and the majority of net present healthcare savings due to PI (76%).

Table 3.2: Estimated cases and healthcare spending incurred for each adverse event with and without whole blood pathogen inactivation for one year.

One year of whole blood PI in Ghana would cost an estimated $8,037,191 ($6,412,577 – $9,817,360) and reduce net present healthcare spending by $9,095,019 ($5,462,082 – $13,343,887) due to averted adverse events, resulting in an annual net savings of $1,057,827 (-$2,683,860 – $5,260,235) (Figure 3.2). Whole blood PI led to an overall reduction in net present healthcare spending in 63% of probabilistic sensitivity analysis iterations. For 14 uncertain input parameters, varying the parameter along its uncertainty ranges led to a variation in the annual net savings of PI of $500,000 or more. For 5 parameters, pathogen inactivation was no longer cost-saving at an extreme value of our uncertainty range. One year of PI had a positive net present cost at the minimum value of our uncertainty range for the baseline risk of sepsis (net present cost of $1,915,019), the risk of clinical outcome for sepsis ($1,785,113), the cost per inpatient day ($248,675), and the number of additional inpatient days needed per cinical sepsis infection ($205,533). PI also had a positive net present cost of $612,682 at the maximum value of our uncertainty range for the per-donation cost of PI (Figure 3.3).

Estimated net impact on healthcare spending of whole blood pathogen inactivation.

Figure 3.2: Estimated net impact on healthcare spending of whole blood pathogen inactivation.

Net impact is the cost of pathogen inactivation minus the net present healthcare savings from avert transfusion-related adverse events.


Sensitivity of the net savings of pathogen inactivation to changes in the value of individual input parameters within prespecified uncertainty ranges.

Figure 3.3: Sensitivity of the net savings of pathogen inactivation to changes in the value of individual input parameters within prespecified uncertainty ranges.

Y-axis shows all model parameters for which varying the value along the indicated range while keeping other parameters at their base case value led to a variation of more than $500,000 in the estimated net savings of whole blood pathogen inactivation.


In a scenario analysis where we accounted for one secondary infection for all HBV, HCV, and HIV-infected recipients, the net present health savings from PI increased from $9,095,019 to $10,919,926 ($6,810,970 – $15,632,667) annually. In this scenario, the net impact of PI was an overall reduction in healthcare spending in 89% of probabilistic sensitivity analysis iterations.