Cost Effectiveness Analysis of PMTCT Service Delivery Modalities in Addis Ababa (Using Decision Models)

Abstract

Background: Identification of cost-effective modalities of PMTCT service delivery is the priority area to decrease the HIV transmission from mother to child. Methodology: The study employed both primary and secondary data to analyse the parameters in the decision model. Result: Cost effectiveness analysis among the three alternatives (no interventions, opt-in and opt-out approach) showed that the opt-out approach would be the most cost effective approach; which would costs 9,597,906 birr ($972,038) and avert 640 cases at CER of 1,989 birr ($201). On the other hand, adopting the opt-in approach would avert 397 and cost 9,318,723 birr ($943,763) at CER of 2,504 birr ($253). Recommendation: Opt-out approach of PMTCT service delivery modality would be the more cost effective strategy as compared to opt-in approach in Addis Ababa. Decisions on recommending particular PMTCT service delivery from economic perspective should be based on the local HIV prevalence, acceptance of VCT and VCT costs.