Abstract
The HPTN 071 (PopART) trial and others have shown that a combination HIV prevention package, including universal testing and treatment (UTT), can reduce the population-level incidence of HIV compared with standard care.1,2 However, evidence on the cost and cost-effectiveness of this strategy has been limited. In The Lancet Global Health, Ranjeeta Thomas and colleagues3 report on a cost-effectiveness analysis model, projecting that combination HIV prevention including UTT (ie, PopART) is cost-effective at thresholds greater than US$800 per disability-adjusted life year (DALY) averted in individuals older than 14 years.
Highlights
In a 2018 study, country-level thresholds for cost per disability-adjusted life year (DALY) averted, based on per-capita gross domestic product, were estimated at $2480–3334 in South Africa and $417–575 in Zambia (2015 US$).[4]
The HPTN 071 (PopART) trial and others have shown that a combination HIV prevention package, including universal testing and treatment (UTT), can reduce the population-level incidence of HIV compared with standard care.[1,2]
In a 2018 study, country-level thresholds for cost per DALY averted, based on per-capita gross domestic product, were estimated at $2480–3334 in South Africa and $417–575 in Zambia (2015 US$).[4]. These estimates suggest that annual implementation of PopART until 2030, as modelled by Thomas and colleagues, would be cost-effective in South Africa ($645 [95% credible interval 538–757] per DALY averted), but not necessarily in Zambia ($593 [526–674] per DALY averted).[3]
Summary
In a 2018 study, country-level thresholds for cost per DALY averted, based on per-capita gross domestic product, were estimated at $2480–3334 in South Africa and $417–575 in Zambia (2015 US$).[4]. The HPTN 071 (PopART) trial and others have shown that a combination HIV prevention package, including universal testing and treatment (UTT), can reduce the population-level incidence of HIV compared with standard care.[1,2] evidence on the cost and cost-effectiveness of this strategy has been limited.
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