+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Costs and benefits to the mother of antenatal HIV testing: estimates from simulation modelling

Costs and benefits to the mother of antenatal HIV testing: estimates from simulation modelling

Aids 13(12): 1569-1576

Objective: To assess the health service costs and benefits for the woman of an earlier HIV diagnosis as a result of antenatal HIV testing. Design: A model of maternal disease progression was developed based on the rate of decline in CD4 cell counts and applied to two matched simulated cohorts of women with identical initial CD4 cell levels and decline rates but whose HIV diagnosis occurred at different times as a result of antenatal HIV testing. UK data on CD4 cell count at HIV diagnosis and annual health service costs of care excluding antiretroviral therapy (ART) incurred at defined states of CD4 cell count were taken from published UK data. Costs of triple ART were added and effectiveness modelled by retarding the rate of CD4 cell count decline. Discounting costs at 6% and life-years at 2% per year, the additional costs per life-year gained by screening were calculated. Uncertainty was explored using sensitivity analysis. Results: Costs per life-year gained by antenatal diagnosis ofwomen were pnd51 258 (dollar sign76 887) assuming untested women were diagnosed a median of 20.4 months later than tested women, ART was initiated at a CD4 cell count of 350 X 106 cells/l and ART efficacy retarded decline in CD4 cell counts by 40% for life. Sensitivity analyses showed results were most sensitive to the assumed efficacy of lifetime ART and time assumed to HIV diagnosis for women not tested in pregnancy. Conclusion: This model provides a way of estimating the additional costs and benefits of future care for the woman resulting from an earlier HIV diagnosis through antenatal testing. These should be included with the paediatric costs averted and life-years gained from interventions to reduce mother-to-child transmission in order to evaluate the cost-effectiveness of antenatal screening in different populations and settings.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 010393529

Download citation: RISBibTeXText

PMID: 10465082

DOI: 10.1097/00002030-199908200-00018

Related references

Antenatal testing--benefits and costs. Seminars in Perinatology 32(4): 318-321, 2008

A new fetal RHD genotyping test: costs and benefits of mass testing to target antenatal anti-D prophylaxis in England and Wales. Bmc Pregnancy and Childbirth 11: 5, 2011

The costs of air quality deterioration and benefits of air pollution control: estimates of mortality costs for two pollutants in 40 U.S. metropolitan areas. American Journal of Economics and Sociology 38(2): 187-195, 1979

Antenatal prevention of the neonatal respiratory distress syndrome: benefits and potential risks for the mother and the infant. Journal of Perinatal Medicine 14(2): 75-86, 1986

Comparing HIV prevalence estimates from prevention of mother-to-child HIV transmission programme and the antenatal HIV surveillance in Addis Ababa. Bmc Public Health 12: 1113, 2012

Cost-effectiveness estimates for antenatal HIV testing in the Netherlands. International Journal of Std and Aids 19(10): 668-675, 2008

Repeated testing, item selection, and relearning: the benefits of testing outweigh the costs. Experimental Psychology 60(3): 206-212, 2013

The costs and benefits of Option B+ for the prevention of mother-to-child transmission of HIV. Aids 28(Suppl. 1): S5, 2014

The ethical implications of antenatal screening for Down's syndrome: Socratic inquiry; The good life?; Calculating the costs and benefits. Bulletin of Medical Ethics No. 147: 13-17, 1999

Uptake, outcomes, and costs of antenatal, well-baby, and prevention of mother-to-child transmission of HIV services under routine care conditions in Zambia. Plos one 8(8): E72444, 2013

An analysis of relative costs and potential benefits of different policies for antenatal screening for beta thalassaemia trait and variant haemoglobins. Journal of Clinical Pathology 52(9): 697-700, 1999

Toxic chemical regulation in Canada: preliminary estimates of costs and benefits. Canadian Public Administration 25(3): 405-419, 1982

Estimates of the benefits and costs from reductions in grass seed field burning. 1997

Benefits of hospital capacity reduction: estimates from a simulation model. Health Services Management Research 9(3): 172-182, 1996

Routine offer of antenatal HIV testing ( opt-out approach) to prevent mother-to-child transmission of HIV in urban Zimbabwe. Bulletin of the World Health Organization 85(11): 843-850, 2007