Vox Sanguinis (2020)

© 2020 International Society of Blood Transfusion

ORIGINAL PAPER DOI: 10.1111/vox.13045

An economic reappraisal of hepatitis B virus testing strategy

for blood donors in Taiwan
Tapiwa Blessing Matanhire1 & Shi-Woei Lin1,2
1
Department of Industrial Management, National Taiwan University of Science and Technology, Taipei, Taiwan
2
Artificial Intelligence for Operations Management Research Center, National Taiwan University of Science and Technology, Taipei, Taiwan

Received: 30 June 2020,
revised 11 November 2020,
accepted 15 November 2020
Abstract
Background and objectives Taiwan is among the few hepatitis B virus (HBV)
high-endemic countries that implement universal mini-pool nucleic acid testing
(MP-NAT) and hepatitis B surface antigen (HBsAg) testing together with confir-
matory individual donor nucleic acid testing (ID-NAT) for its blood supply since
2013. The aim of this study was to reappraise the value of HBsAg test in Tai-
wan’s HBV testing strategy.
Materials and methods A Markov model was constructed, and cost-effectiveness
analysis was conducted in order to reappraise the existing HBV screening strat-
egy in Taiwan.
Results The incremental cost-effectiveness ratio (ICER) for the current testing
strategy in Taiwan was estimated to be $US 443 154 per quality-adjusted life
year (QALY) gained. This is almost six times the willingness-to-pay (WTP) thresh-
old that reflects local preferences.
Conclusion Universal HBsAg and MP-8-NAT together with confirmatory ID-NAT
testing prevents a significant amount of HBV infections from entering the Taiwan
blood supply. However, this comes at a disproportionate increase in cost.
Key words: hepatitis B virus, blood safety, HBsAg test, NAT testing, cost-effec-
tiveness analysis, Markov model.

as HBV from entering into the blood supply, blood opera-

Introduction
HBV is a transfusion-transmitted infection (TTI). It is
prevalent worldwide but has an incidence which varies
across different countries and territories. In highly ende-
mic areas, 70–95% of the population exhibit past or pre-
sent serological evidence of HBV infection [1,2].
Although Taiwan can be categorized as a highly endemic
area, very good progress has been made in fighting
against viral hepatitis since launch of the universal HBV
mass vaccination programme in 1984. At the end of year
2011, it was estimated that at least 700 000 HBV carriers
had been prevented [3]. In an effort to prevent TTIs such
Correspondence: Shi-Woei Lin, Department of Industrial Management,
National Taiwan University of Science and Technology, No. 43, Sec. 4,
Keelung Rd., Taipei 10607, Taiwan
E-mail: shiwoei@mail.ntust.edu.tw
tors around the world implement various safety measures
such as pre-donation selection and laboratory screening
tests [4,5]. Regardless of these safety measures, there is
always some residual risk of infection to transfusion
patients. For example, in 2017, a case of posttransfusion
HBV was reported in a low-endemic country [6].
Blood transfusion operators endeavour to eradicate
residual risk of infection by implementing diagnostic tests
that have a higher degree of sensitivity and specificity
[7]. However, these are expensive which explains why
most developed countries can afford universal HBV-NAT,
whilst the majority of developing countries can only
afford using serologic tests such as HBsAg and anti-HBc
to detect HBV in blood donors [8].
Over the past two decades, a number of countries have
effectively introduced universal HBV-NAT in their testing

1
2 T. B. Matanhire and S.-W. Lin
algorithms [9]. The current practice for the detection of
HBV in Taiwanese blood donors involves the use of uni-
versal HBV-NAT and HBsAg testing. In Taiwan, anti-HBc
testing is not universal because deferring anti-HBc-posi-
tive units critically affects blood supply at a high cost in
medium to high-endemic areas [10]. When the first gen-
eration of HBV-NAT technology was licensed, questions
were raised whether it should replace HBsAg for screen-
ing blood donors [11]. Yet, most developed countries that
added universal HBV-NAT to their testing strategies
retained the HBsAg test. Lack of relevant scientific evi-
dence made it difficult for the regulatory bodies and
experts to support its discontinuation at the time [12,13].
More recently, the value of retaining HBsAg screening
where universal HBV-NAT and anti-HBc tests are used
has become a subject of active discussion by several
researchers, with current evidence indicating diminutive
value in its continued use. Although discontinuing such a
seemingly redundant screening test might result in cost
reduction, the existence of credible ethical and scien-
tific objections makes dropping it highly challenging
[10,14–16].
In spite of the considerations to discontinue HBsAg
screening test as discussed above, the test remains valu-
able in high-endemic areas where the use of anti-HBc is
not universal. Taiwan is among the few high-endemic
countries that implement universal HBV-NAT and HBsAg
testing for its blood supply since 2013 [17]. In a previous
study, a majority of Taiwanese blood donors were found
to be under 30 years old [18] and according to another
study, the anti-HBc-positive rate in this population
appears to have decreased over the past 30 years due to
the extensive infant vaccination programme [19]. There-
fore, giving rise to the question whether Taiwan could
adopt the blood donor policy for low-endemic countries
(excluding the blood donors who are anti-HBc-positive in
order to eliminate the potential sources of occult HBV
infection).
This study aimed to substantiate the value of the
HBsAg test in Taiwan’s HBV blood donor testing strategy.
More specifically, an HBV Markov model was constructed
and cost-effectiveness analysis was conducted in order to
reappraise the existing HBV screening strategy in Taiwan.
The integrated decision analytic model presented in this
paper is adjustable and can readily be reused to perform
economic evaluations of blood donor diagnostic tests for
other related TTIs (see Supporting Information).
First, it is expected that the results of this study can
provide feedback on the performance of the existing HBV
screening strategy in Taiwan. Second, provide recommen-
dations for maintaining, modifying, or changing the
existing strategy. Finally, provide useful insights, guiding
principles or policy recommendations for transfusion
practitioners especially in high-endemic areas.
Materials and methods
Blood donor examination
Taiwan has two centralized testing laboratories in
charge of the nationwide blood examination operations,
at Taipei and Kaohsiung blood centre. Whole blood
donations were screened for HBV between 1 June and
31 November 2017 (six months) at Taipei blood centre.
These donations were tested for HBsAg using Freedom
EVOlyzer and HBV-DNA using Procleix Ultrio Plus
assay (Grifols, Emeryville, CA, USA) on the fully auto-
mated TIGRIS system.
Presently, every donated whole blood unit is univer-
sally tested for HBsAg and HBV-DNA using the testing
algorithm (see Fig. 1) similar to the one described in the
pilot study for introducing NAT for screening blood
donors in Taiwan [20].
Primarily:
(i) HBsAg seronegative and seropositive samples are both
tested for HBV-DNA.
(ii) MP-8-NAT is universally used to test for HBV-DNA,
and reactive samples are confirmed with ID-NAT.
(iii) HBsAg seropositive samples that are unreactive to
MP-8-NAT are tested for HBV-DNA with ID-NAT.
(iv) ID-NAT reactive samples that test positive for both
HBV-DNA and HBsAg are considered as confirmed
cases of HBV infection.
(v) ID-NAT reactive samples that test positive for HBV-
DNA and negative for HBsAg are considered as con-
firmed cases of HBV infection.
(vi) Donors with samples that test HBsAg-positive and
are nonreactive to MP-NAT and ID-NAT are consid-
ered infectious (according to the blood bank policy
since there is no universal anti-HBc testing).
(vii) HBsAg seronegative and MP-NAT nonreactive dona-
tions are classified as negative, and their blood is
permissible for donation.
In order to substantiate the value of HBsAg in the
existing testing algorithm, four blood donation screening
strategies were considered as follows:
(1) No intervention (reference/base case)
(2) HBsAg (EIA)
(3) NAT (MP-8-NAT and ID-NAT)
(4) HBsAg (EIA) plus NAT (MP-8-NAT and ID-NAT)
To begin with, the residual risk of posttransfusion
infection for each screening strategy was determined and
then cost-effectiveness analysis was performed to deter-
mine the optimal strategy. Readers are referred to [21] for
© 2020 International Society of Blood Transfusion
Vox Sanguinis (2020)

Figure 1 General schematic diagram of the HBV blood screening algorithm at Taipei blood centre.
a concise summary of health economic study types rele-
vant to blood safety intervention assessments.
Threat of infection and recipient exposure
Due to the transient nature of HBV, residual risk estima-
tion for HBV is more intricate as compared to that of HIV
and HCV [22]. This value is critical in the analysis of the
cost-effectiveness model and it mainly depends on the
incidence rate, prevalence and window period estimates.
The residual risk estimates were obtained using the inci-
dent rate-WP risk day equivalent model [22,23] (see Sup-
porting Information for more details). Over 80% of the
donations in Taiwan are from repeat donors with an aver-
age annual donation frequency of 1
75.
A recent population-based cohort study estimated
mean age of blood transfusion patients in Taiwan to be
58
4 years [24]. We considered the cohort that included
this demographic group and other limited populations of
susceptible potential recipients of blood products in
which the vaccine nonresponse rate is substantial.
Disease progression model
In order to estimate the costs and effects of an HBV transfu-
sion-transmitted infection, a Markov disease model was
constructed. Stages that have the most significant impact on
© 2020 International Society of Blood Transfusion
Vox Sanguinis (2020)
Economic reappraisal of HBV blood donor tests 3
the disease progression were incorporated to resemble the
natural history of an HBV infection [25]. The Markov model
consists of seven states as depicted in Fig. 2.
All blood donors are tested in the initial state. It is
assumed that diagnostic window period transmissions to
transfusion recipients can occur from this initial state. It
is important to note two things for this Markov model.
First, the acute infection state is temporary because it has
short-term effects. In that regard, it is a tunnel state with-
out a self-loop arrow, which means that a patient cannot
spend no more than a single cycle in the acute infection
state [26]. Second, the Markovian memoryless property is
assumed to those recipients whose acute infection
resolves and acquires lifelong immunity. State transition
probabilities for the model were synthesized from litera-
ture and are provided in Table 1.
Testing costs, disease burden costs and health
utilities
Each state of the Markov model is associated with its
own costs and health utilities. The cost for HBV blood
screening comprised of reagent, equipment, personnel
and other ancillary costs. Costs were estimated at Taipei
blood centre. Disease burden costs for the chronic phases
of hepatitis B were obtained from a Taiwanese study
which was conducted from a national health insurance
4 T. B. Matanhire and S.-W. Lin

Figure 2 Markov state diagram for the natural history of HBV infection (for state transition probabilities, see Table 1).

Table 1 State transition probabilities.

From To Probability Range References

Acute Infection Chronic hepatitis B (CHB) 0
05 (0
02–0
10) [27]

CHB Compensated cirrhosis (CC) 0
0488 (0
02–0
09) [28]
CHB Hepatocellular carcinoma (HCC) 0
0115 (0
008–0
015) [28]
CHB Death 0
0014 (0
0011–0
0017) [28]
CC Decompensated cirrhosis (DC) 0
0572 (0
031–0
099) [28]
CC HCC 0
0391 (0
02–0
071) [28]
CC Death 0
05 (0
049–0
051) [28]
DC HCC 0
0652 (0
047–0
084) [28]
DC Death 0
2506 (0
144–0
39) [28]
HCC Death 0
3713 (0
233–0
433) [28,29]

perspective [30]. The disease burden costs were adjusted
for inflation using the consumer price index for Taiwan.
Due to the spontaneous nature in which acute hepatitis B
resolves, no healthcare costs were attached to the acute
state [31]. The health-related quality of life (HRQoL) of
the recipients who get posttransfusion chronic hepatitis B
is an essential parameter in determining the cost-effec-
tiveness of the blood safety interventions. The HRQoL
values used for the Markov model were obtained from
related literature. The testing costs, disease burden costs
and health utilities are summarized in Table 2. All costs
are denominated in United States dollars.
Economic evaluation
Cost-effectiveness analysis was performed using the Mar-
kov model to compare the four blood donor screening
strategies under consideration. The estimated residual risk
value for each strategy was used to determine the number
of recipients who could get infected with hepatitis B from
transfusion. This study considered HBV transmissions
from the blood donors to the blood recipients but did not
consider potential transmission from the blood recipients
to their partners.
To ensure that the analysis captured important differences
in costs and outcomes, the model was simulated using a life-
time horizon for 35 cycles, with each cycle analogous to a
year. The simulation was run for a cohort of 288 947. Half-
cycle correction was not applied to the model as it often
produces wrong results for discrete Markov models [32].
Costs and health effects were discounted at a rate of 3
5%
per annum for all the Markov state values.
Deterministic sensitivity analysis was conducted to
investigate the effect of varying specific input parameters.
Probabilistic sensitivity analysis (PSA) was also performed
in order to ascertain the overall parameter uncertainty.
Appropriate distributions were assigned for all the input
parameters and fitted using the mean and standard devia-
tion (Table 2). The PSA was repeated for 1000 simulations.
Computational techniques
The health economic model for donor blood testing was
implemented in RStudio using the ‘heemod’ package [33],

© 2020 International Society of Blood Transfusion

Vox Sanguinis (2020)
 Economic reappraisal of HBV blood donor tests 5

Table 2 Input variables.

Parameter Value (95% CI) Distribution Reference

Testing costs (US$)

HBsAg 2
96 (2
03–3
89) Gamma (l, r)* Estimated
NAT 9
80 (7
11–12
49) Gamma (l, r)* Estimated
Drug fees (US$) Gamma (l, r)*
CHB 65
80 (57
21–74
39) Gamma (l, r)* [30]
CC 92
40 (81
57–103
23) Gamma (l, r)* [30]
DC 422
40 (376
8–468
0) Gamma (l, r)* [30]
HCC 704
90 (625
7–784
1) Gamma (l, r)* [29,30]
Hospital fees (US$) Gamma (l, r)*
CHB 192
90 (171
2–214
6) Gamma (l, r)* [30]
CC 265
60 (238
3–292
9) Gamma (l, r)* [30]
DC 1440
30 (1279
7–1600
9) Gamma (l, r)* [30]
HCC 3765
40 (3399–4131) Gamma (l, r)* [29,30]
HRQOL
Acute infection 0
91 (0
89–0
93) Beta (29
81, 2
95) [28]
CHB 0
68 (0
66–0
70) Beta (10
28, 4
84) [28]
CC 0
69 (0
66–0
71) Beta (6
56, 2
95) [28]
DC 0
35 (0
32–0
37) Beta (1
99, 3
70) [28]
HCC 0
38 (0
36–0
41) Beta (1
06, 1
74) [28]
Residual risk probability
No intervention 2
59 9 10-4 (0
002159–0
003025) Binomial (8/5973, 5973) Estimated
HBsAg 17
6 9 10-6 (0
000011–0
000019) Binomial (1/56788, 56788) Estimated
NAT 7
79 9 10-6 (0
000001–0
000003) Binomial (1/128269, 128269) Estimated
HBsAg plus NAT 3
84 9 10-6 (0
000001-0
000003) Binomial (1/260198, 260198) Estimated
Transition probabilities
Acute Infection to CHB 0
05 (0
02–0
10) Binomial (0
05, 100) (see Table 1)
All Markov other states Multinomial (see Table 1)

*Gamma ~ (cost, √cost).

and the results were post-processed to give graphical
summaries by interfacing model results with the global
environment of the ‘BCEA’ package [34].
Results
for the current strategy is almost six times more than soci-
etal WTP threshold. The addition of MP-NAT to HBsAg sig-
nificantly increased the estimated total cost by over 70%.
However, there was slight increase in the estimated net
effectiveness.

Residual risk and infectious Window Period days
The residual risk estimates were found to be 17
6, 7
79
and 3
84 per million donations for ‘HBsAg’, ‘NAT’ and
‘HBsAg plus NAT’, respectively. The lengths of the
infectious window periods are presented in Table 3.
Cost-effectiveness summary
The cost-effectiveness results for the evaluated strategies
are summarized in Table 4. The incremental cost-effective-
ness ratio (ICER) for the current testing strategy in Taiwan
was estimated to be $US 443 614 per QALY, whilst the
willingness-to-pay (WTP) threshold that reflects local pref-
erences is $US 70 000 per QALY [35]. Therefore, the ICER
Deterministic sensitivity analysis
Deterministic sensitivity analyses showed that ICER values
were more sensitive to the residual risk estimates, transition
probability from acute infection to chronic hepatitis B, test-
ing costs and the discount rate, respectively. The tornado
plot for the variables which had the most impact on the
ICER values is shown in Fig. A1 (see Appendix 1). Very
low residual risk estimates significantly increased the ICER
value, whilst higher estimates decreased the ICER value. On
the other hand, very high discount rates significantly low-
ered the ICER value, whilst lower discount rates increased
the ICER value. For example, increasing the discount rate
to 8
5% per annum decreased the ICER value twofold and
this could lead to bias against the HBsAg intervention.

© 2020 International Society of Blood Transfusion

Vox Sanguinis (2020)
6 T. B. Matanhire and S.-W. Lin
Table 3 Residual risk and infectious WP days
Screening strategy Length of infectious WP (days)
HBsAg 41
3
NAT 20
8
HBsAg plus NAT 20
8
Table 4 Cost-effectiveness results
Interventions Estimated total costs (US$) Cost difference (US$)
No Intervention 2 111 712
HBsAg 18 123 911 55
42
NAT 58 023 825 138
10
HBsAg plus NAT 76 115 984 62
61
A cohort of 288 947 was simulated for 35 cycles.
Probabilistic sensitivity analyses
Figure 3 depicts the cost-effectiveness acceptability
curves (CEACs) that quantify the uncertainty in the eco-
nomic re-evaluation model of HBV testing strategies for
blood donors in Taiwan. Implementing the HBsAg strat-
egy is less costly, less effective and over 90% of its joint
density involves cost savings and minimal health gains
when compared to NAT strategies. On the other hand,
both NAT and HBsAg plus NAT strategies are effective to
a certain extent. None of their joint densities are cost sav-
ing but some of them are characterized by some health
gains. Consequently, their probability of cost-effective-
ness is an increasing function of the societal WTP and it
asymptotes to a value around the value of 0
3. It can be
seen that adding NAT to HBsAg slightly increases the
probability of cost-effectiveness as the societal willing-
ness to pay increases. However, the curves for strategies
with NAT flatten as the WTP increases. The overlaid grey
line on the CEACs depicts the cost-effectiveness accept-
ability frontier curve (CEAF) which depicts the range of
WTP values when each of the blood screening interven-
tions is optimal (also see Appendix 2).
Discussion
Taiwan is determined to halt viral hepatitis transmission
by 2030 in line with the vision of the World Health Orga-
nization (WHO) [36]. Hence, ensuring the safety of the
blood supply from TTIs like HBV remains of great impor-
tance in order to keep abreast with that vision. The cur-
rent strategy utilized by Taiwan interdicts a significant
Predicted incidence/million donations
17
6
7
79
3
84
Effectiveness (QALYs) Effectiveness difference (QALYs) ICER (US$/QALY)
10 098 275
10 112 957 0
05 1090
10 113 101 0
00036 386 584
10 113 124 0
00014 443 614
number of HBV infections from entering its blood supply.
However, this significant safety benefit comes at a dispro-
portionate increase in costs. This is evident from the
baseline ICER value of HBsAg plus NAT strategy
($443 614 per QALY) which is significantly higher as
compared to that for the HBsAg strategy ($1090 per
QALY). In light of the existing literature, this result com-
pares to the one reported for a related study conducted in
the Netherlands [37]. However, upon considering the ref-
erence case scenario of our study and that of the Nether-
lands, the screening strategy in Taiwan appears to be
more cost-effective. This is most likely as a result of the
high incidence of HBV in Taiwanese blood donors.
Our economic analysis showed that the value of
HBsAg was a decreasing function of the societal WTP
when compared with NAT. When HBsAg was combined
with NAT, it added minimal value as the societal WTP
increased (Fig. 3). Here, it is important to highlight the
issue of units that test positive for HBsAg only and neg-
ative for other markers such as anti-HBc and HBV-DNA.
These could be as a result of false positives, transient
positivity after vaccination or early stage acute HBV
[14,38,39]. However, to the best of our knowledge, no
such case in Taiwan has been reported as being early
acute HBV.
The scope of this article did not include follow-up
study on the test samples. Therefore, occult HBV (OBI)
cases were not classified. It was evident that use of MP-
8-NAT alongside ID-NAT helps overcome the safety gap
that results from not using the anti-HBc test in Taiwan.
Nevertheless, cases of occult OBI could still occur due to
the dilution factor from pooling the samples. We
© 2020 International Society of Blood Transfusion
Vox Sanguinis (2020)

Figure 3 Cost-effectiveness acceptability curves and frontier. The overlaid grey line shows the effectiveness frontier curve.
speculate that implementing universal ID-NAT could fur-
ther reduce the risk of OBI in Taiwan with very limited
added efficiency and at a much higher cost.
There are some limitations to this study and to our
model. The donor test results that were utilized for analy-
sis were from a 6-month period. Obtaining test data that
covers a longer period would be beneficial in refining the
residual risk estimates. Similar to previous studies [37],
some of the input parameters that populate the model are
single study-based estimates (e.g. HRQoL values). There
are limited published data on region-specific health state
utilities for HBV. This could result in the increase of
uncertainty in such parameter estimates. Despite these
limitations, our model utilized some specific inputs based
on Taiwanese published data, for example the disease
burden costs. Previous studies in Taiwan have mostly
focused on efficacy research of adding NAT to HBsAg
screening in order to increase the safety against TTIs
[20,40]. The results of our study further demonstrate the
benefit of implementing such a screening strategy in
regions having significant OBI carriers such as Taiwan by
conducting cost-effectiveness analysis.
Conclusion
To conclude, our study showed that the strategy of using
universal HBsAg and MP-8-NAT together with confirma-
tory ID-NAT prevents a significant amount of HBV infec-
tions from entering the Taiwan blood supply. However, this
comes at a disproportionate increase in cost. We also found
© 2020 International Society of Blood Transfusion
Vox Sanguinis (2020)
Economic reappraisal of HBV blood donor tests 7
that HBsAg is the preferred choice as indicated on the
CEAF. Additionally, occult hepatitis B remains the main
safety risk for blood transfusion in Taiwan. Excluding anti-
HBc-positive donors might help to eliminate potential
sources of occult HBV infection; however, the main draw-
back for anti-HBc testing is that it results in the loss of a
high percentage of non-infectious carriers thereby seri-
ously affecting the blood supply. Therefore, the HBsAg test
remains valuable in high-endemic areas, especially in those
with blood operators that do not afford to use NAT.
Acknowledgements
This study was partially supported by the Ministry of
Science and Technology of Taiwan under the grant num-
ber MOST 103-2410-H-011-012-MY3 and MOST 106-
2410-H-011-004-MY3. Any opinions, findings, and con-
clusions or recommendations expressed herein are those
of the authors and do not necessarily reflect the views of
the sponsors.
Conflicts of interest
The authors declare that they have no conflicts of interest
relevant to the manuscript submitted to Vox Sanguinis.
Authors contributions
All authors listed meet the authorship criteria and con-
tributed to research design, data acquisition, analysis and
8 T. B. Matanhire and S.-W. Lin

interpretation, writing, critical review and approval of the
manuscript. Here we indicate the specific contributions
made by each author. Conceptualization/Methodology:
Shi-Woei Lin, Tapiwa Blessing Matanhire. Acquisition,
Analysis and/Interpretation of data: Tapiwa Blessing
Matanhire, Shi-Woei Lin. Writing-Original Draft
Preparation: Tapiwa Blessing Matanhire. Review: Shi-
Woei Lin, Tapiwa Blessing Matanhire. Visualization:
Tapiwa Blessing Matanhire. Final approval of version for
submission: Shi-Woei Lin, Tapiwa Blessing Matanhire.
Supervision/Project Administration/Funding Acquisi-
tion: Shi Woei Lin.

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Supporting Information
Additional Supporting Information may be found in the online version of this article:

ICER (US$/QALY)

HBsAg residual risk 343,750 1,150,000

Acute infection to Chronic HBV (transition probability) 237,500 581,250

NAT cost 225,000 513,260

Discount rate 166,250 392,600

NAT residual risk 281,750 386,000

Figure A1 Tornado plot. The chart shows the sensitivity of the parameters around the ICER value of 386 585 between the HBsAg and the NAT strate-
gies.

Table A1 Net monetary benefit.

Societal WP value

$80 000 $160 000 $240 000 $320 000 $6 40,000 $1 280 000 $2 560 000 $5 120 000

No Intervention 0 0 0 0 0 0 0 0
HBsAg 4009 8074 12 138 16 203 32 462 64 981 130 017 260 091
NAT 3899 7993 12 086 16 179 32 553 65 300 130 794 261 781
HBsAg plus NAT 3848 7953 12 057 16 162 32 581 65 418 131 092 262 441

The number in bold shows the highest net monetary value at that particular WTP threshold value, and the corresponding strategy is optimal at that
threshold.

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Vox Sanguinis (2020)
10 T. B. Matanhire and S.-W. Lin

Supplementary Material R code for the economic evaluation of hepatitis B virus testing strategies

Table S1 Input parameters and risk calculations results.

Table S2 Test yield and result classification.
Table S3 Parameters for fitting the Beta distribution.
Table S4 Multinomial distribution for state transition probabilities.
Figure S1 Pdf chart for CHB HRQoL (Beta).
Supplementary Material #Model Parameters

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Vox Sanguinis (2020)