Table 3.
Health impacts and cost of expanded access to key populations over 20 years, compared to 2010 eligibility guidelines and status quo health access (all costs in 2012 US dollars)
| Percent of infections averteda |
DALYs averted (000s)b |
Additional cost (millions)c |
ICERd | |
|---|---|---|---|---|
| India | ||||
| Belgaum | ||||
| FSW, status quo access | 13% | 3.5 | $0.2 | $85 |
| all HIV+, status quo access | 21% | 9.0 | $1.6 | $268 |
| all HIV+, prioritised FSW | 29% | 11.0 | $2.3 | $395 |
| all HIV+, universal access | 52% | 33.8 | $123.9 | $5,648 |
| Belgaum, no condom | ||||
| FSW, status quo access | 1% | 0.9 | $0.1 | $73 |
| all HIV+, status quo access | 1% | 2.2 | $0.5 | -- |
| all HIV+, prioritised FSW | 41% | 37.6 | $4.0 | $123 |
| all HIV+, universal access | 66% | 108.9 | $138.7 | $2,054 |
| Vietnam | ||||
| Prevtool | ||||
| FSW, status quo access | 2% | 41.5 | $5.9 | $161 |
| MSM, status quo access | 5% | 146.2 | $37.1 | -- |
| PWID, status quo access | 5% | 149.1 | $36.8 | -- |
| CD4 ≤500, status quo access | 4% | 175.6 | $47.5 | -- |
| all HIV+, status quo access | 12% | 367.1 | $96.4 | $305 |
| CD4 ≤500, prioritised FSW, MSM, PWID | 30% | 1497.5 | $2,442.6 | -- |
| all HIV+, prioritised FSW, MSM, PWID | 52% | 2082.5 | $2,485.7 | $1,586 |
| CD4 ≤500, universal access | 37% | 2544.5 | $25,692.5 | -- |
| all HIV+, universal access | 63% | 3278.2 | $25,725.4 | $21,550 |
Percentage of infections averted over 20 years compared to CD4 ≤350 cells/µL eligibility with status quo access (undiscounted).
Cumulative disability-adjusted life-years averted compared to CD4 ≤350 cells/µL eligibility with status quo access (undiscounted).
Cumulative additional cost over 20 years compared to CD4 ≤350 cells/µL eligibility with status quo access (undiscounted).
Incremental cost per DALY averted over 20 years relative to previous undominated strategy, ‘--‘ indicates a dominated strategy (either weak or strong). Costs and health outcomes discounted at 3% per annum.