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To the Editor: In 1994 we reported a cost-effectiveness analysis for solvent-detergent–treated frozen plasma (SDFP),¹ in which we calculated a cost of $289,300 per quality-adjusted life year (QALY) saved. Solvent-detergent treatment involves pooling several thousand units of donated plasma, then applying a detergent to inactivate enveloped viruses such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV). This technique decreases the transmission risk for these viruses, although it theoretically can increase the transmission risk for nonenveloped viruses. Despite the poor projected cost-effectiveness of SDFP, the Food and Drug Administration has recently licensed it for use in the United States, with distribution being handled by the American Red Cross Blood Services.

Since our initial analysis was published, several of the assumptions used in the analysis have changed. Improved viral screening has led to new, lower estimates of HIV, HCV, and HBV transmission risk,² and the marginal . . . [Full Text of this Article]

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