Table 2.
Cost and economic analyses of the SMS and LEN-LA strategy
| Routine | SMS | LEN-LA | |
|---|---|---|---|
| Total HIV infection | 28,124 (27,845–28,403) | 21,933 (21,677–22,191) | 12,339 (12,136–12,544) |
| HIV-related deaths | 5,459 (5,319–5,602) | 3,359 (3,248–3,473) | 2,892 (2,789–2,998) |
| QALYs | 2,569,209 (2,567,706–2,570,693) | 2,591,805 (2,591,464–2,592,278) | 2,600,954 (2,600,315–2,601,724) |
| C (total cost), US$ million | 367.08 (362.26-371.86) | 406.46 (402.11-411.41) | 109,886.88 (108,040.45-111,402.01) |
| CIntervention | 0 | 109.15 (109.10-109.19) | 109,694.93 (107,814.46-111,081.73) |
| CART−treatment | 367.08 (362.26-371.86) | 297.31 (292.87-302.73) | 191.95 (184.90-199.73) |
| SMS vs. Routine | LEN-LA vs. Routine | LEN-LA vs. SMS | |
| Intermediate outcomes | |||
| ΔC (incremental cost), US$ million | 39.38 (36.89–40.93) | 109,499.80 (107,704.81-111,133.83) | 109,480.42 (108,139.42-110,995.77) |
| ΔCIntervention | 109.15 (106.19-111.02) | 109,694.93 (107,759.96-111,227.80) | 109,585.78 (107,801.03-111,108.61) |
| ΔCART−treatment | 69.77 (67.63–71.47) | 175.13 (170.59-178.98) | 105.36 (76.94-138.81) |
| ΔE (QALYs averted) | 22,596 (22,217–22,939) | 31,745 (31,104–32,476) | 9,149 (8,804–9,511) |
| ΔInfection | 6,191 (6,042–6,342) | 15,785 (15,560–16,012) | 9,594 (9,412–9,778) |
| ΔDeaths | 2,100 (2,012–2,191) | 2,567 (2,470–2,667) | 467 (426–511) |
| Cost-effectiveness analysis (CEA) | |||
| ACER, US$/infection |
6,361 (5,959–6,613) |
6.95 million (6.82 million-7.04 million) |
11.41 million (11.28 million-11.56 million) |
| ACER, US$/death |
18,752 (17,274–20,530) |
42.62 million (41.67 million-43.61 million) |
234.43 million (231.56 million-237.73 million) |
| Cost-utility analysis (CUA) | |||
| ICER (ΔC/ΔE), US$/QALY | 1,743 (1,673–1,799) | 3,449,987 (3,363,757–3,557,755) | 11,967,321 (11,434,873–12,608,953) |
| Cost-benefit analysis (CBA) | |||
| ΔB (ΔCART−treatment + λΔEa), US$ million | 216.63 (211.83-220.99) | 577.50 (562.76-586.13) | 226.96 (222.54-231.55) |
| NMB (ΔB –ΔCIntervention), US$ million | 107.48 (102.68-111.61) | -108,922.34 (-108,931.47 to -108,911.40) | -109,812.74 (-109,817.19 to -109,806.76) |
| BCR (ΔB/ ΔCIntervention) | 1.98 (1.94–2.02) | 0.0053 (0.0052–0.0054) | 0.0021 (0.0019–0.0022) |
Note: 95% confidence intervals are in parentheses
aThe λΔE represented the monetized averted QALY benefit, with λ meaning the threshold of willingness-to-pay (WTP) set at 1 × national per capita gross domestic product (pGDP) of US$12,675
Abbreviations: QALYs, quality-adjusted life-years; ACER, average cost-effectiveness ratio; ICER, incremental cost effectiveness ratio; NMB, net monetary benefit; BCR, benefit-cost ratio