Cost-effectiveness of different intervention strategies of HIV in Zhejiang, China.

IF 3.4 2区 医学 Q3 IMMUNOLOGY
AIDS Pub Date : 2024-11-01 Epub Date: 2024-06-25 DOI:10.1097/QAD.0000000000003968
Chensi Wu, Xiaolan Xu, Chunting Peng, Yin Dong, Zhuoqi Lou, Liya Pan, Lin Chen, Yifan Zeng, Bing Ruan
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引用次数: 0

Abstract

Objective: Mass screening for HIV and preexposure prophylaxis (PrEP) may be effective measures for reducing the probability of HIV transmission. Our study aimed to determine the cost-effectiveness of preliminary screening in the general population, PrEP for HIV-negative spouses in serodiscordant couples, or both approaches in Zhejiang Province.

Design: From a policy-maker's perspective, a Markov model was constructed to compare four strategies over a 30-year horizon.

Methods: In the Markov model, the implementation intensities of the strategies varied from 50 to 100%. Different strategies were evaluated by the reduction of unfavorable clinical outcomes, saved life-years, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and net monetary benefits (NMBs).

Results: The PrEP-screening strategy reduced the most unfavorable clinical outcomes and saved the most life-years and QALYs from 2023 to 2052. It always gained the maximum QALYs and NMB, while its ICER was always lower than the willingness-to-pay (WTP). The NMB of the PrEP-screening strategy gradually increased as the implementation intensity increased.

Conclusion: With adequate manpower and policies, we suggest implementing the PrEP-screening strategy in Zhejiang Province, suggesting that the broader the population coverage of the strategy, the better. In addition, the PrEP strategy is an alternative.

中国浙江不同人类免疫缺陷病毒干预策略的成本效益:2023 年至 2052 年的模型研究。
目的: :大规模的人类免疫缺陷病毒(HIV)筛查和暴露前预防(PrEP)可能是降低HIV传播概率的有效措施。我们的研究旨在确定在浙江省对普通人群进行初步筛查、对血清不一致夫妇中 HIV 阴性配偶进行 PrEP 或同时采取这两种方法的成本效益。结果::从 2023 年到 2052 年,PrEP-筛查策略减少了最多的不利临床结果,挽救了最多的生命年(LYs)、质量调整生命年(QALYs)、增量成本效益比(ICERs)和净货币收益(NMBs)。它始终获得最大的 QALYs 和 NMB,而其 ICER 始终低于支付意愿 (WTP)。结论:在人力和政策充足的情况下,我们建议在浙江省实施 PrEP 筛选策略,这表明该策略的人群覆盖面越广越好。此外,PrEP 策略也是一种选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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