Assessment framework for donor blood screening

Transfusion-transmitted infections can have serious consequences for the health of blood recipients, which is why donor blood is screened for pathogens. The Dutch blood-supply organisation currently tests all blood donations for five infectious diseases. However, donor blood screening is not always cost-effective: because donor blood is rarely contaminated, extensive testing is required in order to identify a single contaminated sample. While legitimate arguments can be made for the continuation or introduction of a cost-ineffective testing measure, it is not always clear what these arguments are. At the request of the State Secretary for Health, Welfare and Sport, the Health Council of the Netherlands has drawn up an assessment framework that will help to make such considerations explicit – not only the formal, quantifiable criteria, but also the ethical and societal factors at play. The ultimate assessment should clearly demonstrate why a cost-ineffective test was (or was not) recommended.