Health Economics Evaluation Of Mother-to-child Transmision Of HIV In ShenZhen

Objectives: Create a better economic evaluation system to analysis effectiveness ,benefit and utility of MTCT of HIV prevention and control program in Shenzhen city. It can provide scientific evidence for guidance AIDS prevention and control, optimization, rational allocation and using resources, reducing the individual patients and the government's financial burden, and help health managers make decision about program.Methods: From July 2002 to Dec 2005,collected data about the number of the maternal HIV antibody screening and HIV infected pregnant women, pregnancy outcomes, treatment interventions, the costs of care and treatment of AIDS , the costs of the program. And reference data for research form aboard and choosing parameters related project to establish evaluation system. Calculate the total costs of program, the rate of HIV infected during pregnancy women,the numbers of HIV infection averted by the program, the economic benefit got by the program ,the quality-adjusted life years(QALYs) saved by program. Analysis of cost-effectiveness,cost-benefit and cost-utility, as well as the results of an evaluation of sensitivity analysis.Results: A total of 464486 pregnant women receive free HIV antibody screening, detection of which 53 positive, and the positive rate for 1.14/10000.The total program cost 8651855.61 yuan,the cost screening 8538979.96 yuan,which is 98.7% of the total cost. The remaining cost(including the cost of diagnosis, the drug costs,costs increased by cesarean ,costs of feeding formula)is 112875.65 yuan,which is 1.3% of the total cost. Through the implementation of the program,it will be able to avoid HIV infection for 48 cases, of which 18 neonatal infection can be directly avoid and 30 adult infection can be indirectly avoided. It can get the economic benefit 44474686.77 yuan, including 14689159.49 yuan direct benefits and 29785527.28 yuan indirect benefits. And net benefit is 35822831.16 yuan. By program the total of QALYs are 1045.92 which can be saved. Economic evaluation suggests:161778.49 yuan will be spent by diagnosis a positive pregnant woman; 180246.99 yuan will be spent by averting an HIV infection; BCR is 6.30;CUR is negative. Sensitivity analysis shows that the cost of averting an HIV infection will be up to 389423.24 yuan;BCR will be at least 1.84 yuan;and CUR will be up to 12461.82 yuan/QALY.Conclusions:1.During July 2002 and Dec 2005,the number of acceptance of HIV antibody screening of pregnant women are 464486 .The total positive rates(/10000)were 1.14.The total cost of program is 8651855.61 yuan.2.After implementation of the program, the number of averting HIV infection is 48;reducing economic losses is 44474686.77 yuan;the net benefits is 35822831.16 yuan;CUR is negative. 3.Sensitivity analysis shows,the minimum of BCR is 1.84;the maximum of CUR is 12461.82 yuan/QALY.It suggest that results of the evaluation of program stable and reliable.