Alternatives of Plasma for Transfusion to Patients [Internet]

Excerpt

Plasma transfusion is used to stop or prevent bleeding. Currently, all plasma used for transfusion at Norwegian hospitals (50,000 units per year) is the plasma product Octaplas®. Each unit (200 mL) contains a mix of plasmas from around 1,000 donors, and is treated chemically using solvent-detergent to eliminate virus, bacteria and parasites (pathogens). Several alternative plasma products are available on the market, and there are concerns about the costs of purchasing Octaplas® and whether these costs are too high compared with other plasma products. Alternatives to Octaplas® may be based on plasma from only one or several donors and/or other methods of eliminating pathogens (pathogeninactivation). This is the background for the commission by the “Bestillerforum RHF” to the Norwegian Knowledge Centre for the Health Services to conduct a health technology assessment (HTA), which has compared the various alternatives for generation of plasma for transfusion purposes in terms of clinical effectiveness, safety and costs.

Main results are the following:

Clinical effectiveness

1. According to availble documentation, it is not possible determine whether there are differences in terms of clinical effectiveness between the different plasma alternatives assessed.

Safety

1. Based on registry data, it seems that the various types of plasma routinely used in various European countries are safe in terms of adverse events.

2. Pathogen-inactivated plasma appears to be the safest alternative.

3. There might be some indications that certain methods of pathogen inactivation may lead to more allergies than others, but the evidence is both sparse and partly inadequate.

Costs

1. Fresh frozen and quarantined plasma have the lowest costs among the alternatives evaluated.

2. Pathogen-inactivated plasma produced in-house represents the middle level of costs while purchase of Octaplas® incurs the highest costs.

3. An important assumption in our analysis is that plasma, which is not used for transfusion, can be sold at the market price.