LAUSR

We appreciate the detailed comments provided by Dr. Paul Mintz regarding our paper “Economic Implications of Pathogen Reduced and Bacterially Tested Platelet Components: A US Hospital Budget Impact Model [1].” To provide a brief context, the purpose of this model is to estimate the financial impact of adopting new approaches to reduce bacterial contamination of platelet components, from a hospital perspective. These techniques include pathogen reduction (PR-PC), rapid bacterial testing (RT-PC), and secondary culture [2, 3]. It should be noted that the latter is among the acceptable techniques included in US Food and Drug Administration guidance and is built into our model but was not reported in the paper scenarios because, as of this writing, it is not commonly used. The model itself was constructed in an adaptable software platform, with model scenarios described and presented in the paper. The reader’s first comment is that our model “falsely presumes a significantly greater number of PGD (Verax Biomedical Pan Genera Detection) tests per component.” For clarification to those unfamiliar with platelet testing, PGD is a rapid test that falls under the RT-PC model assumptions. The reader’s assertion is not true. In the model, the user specifies the distribution of platelets by day of transfusion applicable to their institution. The distribution of platelet usage and RT-PC tests in the paper scenario is shown in Table 1. Based on this, the average number of tests applicable to the scenario presented in the paper is (1 × 0.32) + (2 × 0.20) + (3 × 0.06) + (4 × 0.06) = 1.14 tests. This is comparable to the values quoted by the reader, and consequently, the incremental cost of rapid tests beyond the first is a minor contributor to total RT-PC costs presented in the paper. With regard to Dr. Mintz’s point, the optimized scenario would be one in which just one rapid test is performed, and it is completed in anticipation of using the unit within 24 h. This test may occur as early as day 4 but up to day 7. To provide readers with a frame of reference regarding the financial impact of changing the model inputs to assume just one test per unit, we provide the following post-hoc calculations.