Would Universal Antenatal Screeing for HIV Infection Be Cost-Effective in a Setting of Very Low Prevalence? Modelling the Data for Australia
Graves, Nicholas, Walker, Damian, McDonald, Anne M., Kaldor, John M., & Ziegler, John B. (2004) Would Universal Antenatal Screeing for HIV Infection Be Cost-Effective in a Setting of Very Low Prevalence? Modelling the Data for Australia. Journal of Infectious Diseases, 190(1), pp. 166-174.
Background: The economics of universal antenatal HIV screening should be explored if mother-to-child transmission of HIV occurs, the health service infrastructure exists for universal screening and optimal risk reducing treatments can be supplied. Published cost-effectiveness analyses of universal antenatal HIV screening conducted for high-income countries have assumed prevalence’s of >0.01%, for the base case, among the antenatal population. We model data for Australia, where prevalence is very low, to examine whether universal antenatal HIV screening is cost-effective in this setting. Methods: A static-decision-model of the incremental cost-effectiveness of universal antenatal-HIV-screening as compared to existing practice was developed. We evaluated a hypothetical cohort of the antenatal population of Australia for 2001-2002. A quasi-societal perspective was adopted, secondary data sources used and sensitivity analyses undertaken. All data relate to 2001-02 and costs and benefits incurred in the future were discounted to their present value. Results: The intervention would be cost-effective if the prevalence of undiagnosed HIV in the currently unscreened Australian antenatal population was ≥ 0.004372% (1 case in 22,872). At this prevalence, incremental costs are exactly offset by incremental benefits. We predict 6.95 new diagnoses of HIV, 1.73 infections avoided and 46.97 discounted-life-years gained. Applying favourable and unfavourable values for key variables suggests the prevalence at which the intervention would be cost-effective lies between 0.0016-0.0106% (1:62,500 – 1:9,434). Conclusions: Universal antenatal HIV screening infection would be cost-effective at a very low prevalence and would generate net benefits under many scenarios; accurate statistics on the true prevalence of HIV in the currently unscreened antenatal population are required.
Citation countsare sourced monthly fromand citation databases.
These databases contain citations from different subsets of available publications and different time periods and thus the citation count from each is usually different. Some works are not in either database and no count is displayed. Scopus includes citations from articles published in 1996 onwards, and Web of Science® generally from 1980 onwards.
Citations counts from theindexing service can be viewed at the linked Google Scholar™ search.
Full-text downloadsdisplays the total number of times this work’s files (e.g., a PDF) have been downloaded from QUT ePrints as well as the number of downloads in the previous 365 days. The count includes downloads for all files if a work has more than one.
|Item Type:||Journal Article|
|Keywords:||HIV, AIDS, cost, effectiveness analysis, economic evaluation, Australia, antenatal, screening|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700)|
|Divisions:||Current > Research Centres > Centre for Health Research|
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
|Copyright Owner:||Copyright 2004 University of Chicago Press|
|Copyright Statement:||Reproduced in accordance with the copyright policy of the publisher.|
|Deposited On:||16 May 2007|
|Last Modified:||29 Feb 2012 23:04|
Repository Staff Only: item control page