Table 5.

CEA with a health outcome: cost per HIV infection averted

	Pre-training	Post-training
Program cost
Remuneration
Clinical staff, including counselors	$65,000	$72,000
Supervisory staff	$15,000	$12,000
Total remuneration	$80,000	$84,000
Supplies, including HIV test kits and ARV drugs	$15,000	$18,000
Capital (annuitized)
Vehicle	$3,000	$3,000
Equipment	$500	$500
Building	$1,500	$1,500
Training	$0	$5,000
Total Capital	$5,000	$10,000
Total program cost	$100,000	$112,000
Estimate of effectiveness
Number of mother infant pairs that PMTCT	1000	1200
Estimated vertical HIV transmission before and at birth*
Base case	25%	25%
Lower bound	19%	19%
Upper bound	30%	30%
Effectiveness of regimen for mothers and infant	63%	63%
Estimated HIV infections averted
Base case	(1000*.25*.63) =158	(1000*.25*.63) =189
Lower bound	120	144
Upper bound	189	227
Cost-effectiveness analysis
Incremental cost	($112,000-$100,000) = $12,000
Incremental HIV infection averted
Base case		(189–158) = 31
Lower bound		(144–120) = 24
Upper bound		(227–189) = 38
Incremental cost-effectiveness ratio (ICER)
Base case		($12,000/31)=$283
Lower bound		$215
Upper bound		$340

*The effect of the training on MTCT is uncertain because there is a range of estimates for vertical HIV transmission before and during birth. The midpoint of the range is used to estimate effectiveness for the base case, and a sensitivity analysis is conducted with the lower and upper bounds. The base case and range are also reported for the number of HIV infections averted and ICER.