Universal Rapid Human Immunodeficiency Virus Screening at Delivery: A Cost-Effectiveness Analysis.
Citation: Infectious Diseases in Obstetrics & Gynecology. 2018:6024698, 2018.PMID: 29731602Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *HIV Infections/di [Diagnosis] | *Infectious Disease Transmission, Vertical/pc [Prevention & Control] | *Mass Screening/ec [Economics] | *Mass Screening/mt [Methods] | Adolescent | Adult | Cost-Benefit Analysis | Female | HIV Infections/ec [Economics] | Humans | Incidence | Middle Aged | Pregnancy | Prevalence | Quality-Adjusted Life Years | United States/ep [Epidemiology] | Young AdultYear: 2018Local holdings: Available online from MWHC library: 1998 - presentISSN:- 1064-7449
- Scott, Rachel K:
- https://orcid.org/0000-0002-1519-9222
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 29731602 | Available | 29731602 |
Available online from MWHC library: 1998 - present
Conclusions: Intrapartum universal rapid HIV screening to decrease MTCT appears cost-effective in populations with high HIV incidence in the United States.
Objective: To determine the cost-effectiveness of universal maternal HIV screening at time of delivery to decrease mother-to-child transmission (MTCT), by comparing the cost and quality-adjusted life years (QALYs) of universal rapid HIV screening at time of delivery to two current standards of care for prenatal HIV screening in the United States.
Results: The incremental cost-effectiveness ratio for universal screening was ,973.45/QALY. The results remained robust to sensitivity analysis, except for annual cumulative incidence. In areas with an annual cumulative incidence rate of <0.02% for reproductive-age women, the incremental cost-effectiveness ratio for the expanded program would exceed 9,926.94/QALY, approaching the commonly applied cost-effectiveness thresholds ( 00,000/QALY).
Study Design: We conducted a cost-effectiveness analysis to compare the cost and QALY of universal intrapartum rapid HIV screening with two current standards of care: (I) opt-out rapid HIV testing limited to patients without previous third-trimester screening and (II) opt-out rapid HIV testing limited to patients without any prenatal screening. We developed a decision-tree model and performed sensitivity analyses to estimate the impact of variances in QALY, estimated lifetime medical costs, HIV prevalence, and cumulative incidence.
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