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Vaginal microbicides save money: a model of cost-effectiveness in South Africa and the USA

Vaginal microbicides save money: a model of cost-effectiveness in South Africa and the USA,10.1136/sti.2009.037176,Archives of Disease in Childhood,S.

Vaginal microbicides save money: a model of cost-effectiveness in South Africa and the USA   (Citations: 1)
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ObjectiveTo determine the hypothetical cost-effectiveness of vaginal microbicides preventing male to female HIV transmission.MethodsA mathematical epidemiological and cost-effectiveness model using data from South Africa and the USA was used. The prospective 1-year-long intervention targeted a general population of women in a city of 1 000 000 inhabitants in two very different epidemiological settings, South Africa with a male HIV prevalence of 18.80% and the USA with a male HIV prevalence of 0.72%. The base case scenario assumes a microbicide effective at 55%, used in 30% of sexual episodes at a retail price for the public sector in South Africa of US$0.51 per use and in the USA of US$2.23 per use.ResultsIn South Africa, over 1 year, the intervention would prevent 1908 infections, save US$6712 per infection averted as compared with antiretroviral treatment. In the USA, it would be more costly: over 1 year, the intervention would prevent 21 infections, amounting to a net cost per infection averted of US$405 077. However, in the setting of Washington DC, with a higher HIV prevalence, the same intervention would prevent 93 infections and save US$91 176 per infection averted. Sensitivity analyses were conducted and even a microbicide with a low effectiveness of 30% would still save healthcare costs in South Africa.ConclusionsA microbicide intervention is likely to be very cost-effective in a country undergoing a high-level generalised epidemic such as South Africa, but is unlikely to be cost-effective in a developed country presenting epidemiological features similar to the USA unless the male HIV prevalence exceeds 2.4%.
Journal: Archives of Disease in Childhood - ARCH DIS CHILD , vol. 86, no. 3, pp. 212-216, 2010
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