OBJECTIVES : Blood transfusions are commonly used to treat patients with conditions relating to insufficient red blood cells (RBCs). However, in-vitro evidence indicates that the storage process of RCBs may result in oxidative damage with subsequent risk of adverse transfusion outcomes. Hypoxic stored RBCs have the potential to increase blood quality and reduce the number of transfusions required. Extending transfusion intervals can benefit those receiving chronic transfusions by enhancing the patient’s quality of life and reducing transfusion-related adverse events. The use of expensive drugs for this purpose is also reduced, resulting in lower healthcare costs. The aim of this study was to demonstrate the cost-effectiveness of using hypoxic stored RBCs instead of standard stored RBCs in transfusions for patients with sickle cell anaemia, thalassemia and myelodysplastic syndrome.

METHODS : Three separate decision tree models, populated using published data, were employed to compare treatment strategies for sickle cell anaemia, thalassemia and myelodysplastic syndrome. Costs (expressed in local currencies) and health benefits (expressed in quality-adjusted life-years) were attached to each arm of the models to evaluate the comparative cost-effectiveness of using hypoxic stored RBCs for chronic transfusions. The models were adapted to France, Germany, Italy, Norway and the UK. Different types of sensitivity analysis were conducted to determine the robustness of the results.

RESULTS : The analysis showed that the incremental health benefit offered by hypoxic stored RBCs is greater than that of standard stored RBCs. Additionally, using hypoxic stored RBCs led to lower healthcare costs. Therefore, hypoxic stored RBCs was found to be more cost-effective. Other important outcomes were reduced mortality and adverse events due to the reduction of blood transfusions. Results remained robust in sensitivity analysis.

CONCLUSIONS : The results of this study showed that using hypoxic versus standard stored RBCs is cost-effective in treating patients with conditions requiring chronic transfusions.