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Am J Obstet Gynecol. 1996 Feb;174(2):716-21.

The cost-effectiveness of human immunodeficiency virus screening in pregnancy.

Author information

1
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA.

Abstract

OBJECTIVE:

My purpose was to evaluate the cost-effectiveness of screening for human immunodeficiency virus during pregnancy as part of a protocol in which zidovudine was used to reduce the risk of vertical transmission.

STUDY DESIGN:

This mathematic model used decision analysis to calculate the marginal cost-effectiveness of screening for human immunodeficiency virus in pregnancy and treating human immunodeficiency virus-positive women with zidovudine. Cost and probability assumptions were drawn from a literature review. Sensitivity analyses were performed for important costs and probabilities.

RESULTS:

When baseline cost and probability assumptions were used, the marginal cost-effectiveness of human immunodeficiency virus screening was $436,927 when the prevalence of human immunodeficiency virus in the population was low (0.00075) and $198,510 when the prevalence was average (0.0015). Above a prevalence of human immunodeficiency virus of 0.009, testing is both cheaper and more effective than not testing. Of the cost variables examined, the charge for a negative testing sequence had the greatest impact on cost-effectiveness.

CONCLUSION:

Human immunodeficiency virus testing in pregnancy is cost-effective in populations in which the prevalence of human immunodeficiency virus exceeds 9 per 1000 population. Depending on how individual lives saved are valued, screening may also be warranted in populations with lower prevalences of infection.

PMID:
8623812
[Indexed for MEDLINE]

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