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Abstract
A comparison of economic analyses of nevirapine for prevention of mother to child transmission of HIV
G Schmid1, M Sweat2, K O'Reilly1, I de Zoysa1
1World Health Organization, Geneva, Switzerland; 2The Johns Hopkins University, Baltimore, United States
Background: Economic analysis (EA) of intervention options is critical to sound policy decisions and resource utilization. EA is complex, however. Results of analyses may differ markedly from one another depending upon the parameters and estimates used, and the applicability of individual EAs to specific countries/situations may vary considerably. EAs of the use of nevirapine (NVP) for prevention of mother to child transmission (PMTCT) have stimulated great interest in this important intervention, yet assumptions and results have varied among them.
Methods: We compared three recent EAs of PMTCT to examine the variability in parameters and estimates made among the analyses and to understand the results of each.
Results: While many parameters and estimates are similar, there are important differences across the EAs, including inclusion or estimates of three important parameters: (1) cost of voluntary counseling and testing (VCT); (2) proportion of pregnant women accepting VCT and NVP; (3) health care system costs to “scale-up” successful PMTCT efforts. These differences are sufficient to cause considerable variation among the EAs, including whether or not the results might be considered “cost-effective,” e.g., cost/case averted, $81, $506, $2,538 at a prevalence of HIV infection of 15%. These differences simultaneously highlight areas where additional data are needed to refine EAs, perhaps on a country level, or where lower costs are needed to effectively implement a PMTCT program.
Conclusions: Policy-makers must understand the variability among models and be able to judge their applicability to their individual situations. While estimates will legitimately differ from one country to another, it is important that EAs of NVP use for PMTCT develop better consensus on the cost of VCT and health system enhancement, and the proportion of women who accept and receive NVP in different settings, to better guide policy makers.
The XIV International AIDS Conference
Abstract no.
TuPeE5165
Suggested Citation
" G Schmid , , et al.
A comparison of economic analyses of nevirapine for prevention of mother to child transmission of HIV
.
Poster Exhibition:
The XIV International AIDS Conference:
Abstract no.
TuPeE5165"
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