Health economics evaluation of the cost and effectiveness of gray zone setting in blood ELISA screening

Objective To analyze the cost-effectiveness of ELISA grey area strategy through establishing the health economics model. Methods The serological grey area strategy evaluation model was composed of screening strategy subdecision tree, pathogen infection subdecision tree and pathogen detection subdecision tree. The key parameters in the model were obtained from literatures and research data. The cost-effectiveness of setting ELISA grey area strategy was compared by software, and multifactor sensitivity analysis was conducted. Results After setting the ELISA grey area, extra samples(5.86 cases/100 000) with serological false negativity could be detected, including HBV samples at 4.93/100 000, HCV samples at 0.27/100 000, HIV samples at 0/100 000, syphilis samples at 0.66/100 000. To yield an additional seropositive sample out of every 100 000 blood donors, blood center will afford extra 1 million yuan about. Conclusion Through this study, a cost-effectiveness evaluation model of serological detection strategy was established. Although the ELISA grey area setting can yield a small number of seropositive samples, the cost is much higher than the current affordability.