Table 2. Base Case Assumptions and Estimated Number of HIV Infections Averted over 10 Years for Each Strategy.
Status Quo* | OST | HHRP+ | HHRP+ Low | 3H+ | OST & HHRP+ | OST & 3H+ | |
---|---|---|---|---|---|---|---|
Fraction with access to harm reduction | |||||||
PWID | 0.00 | 0.00 | 0.80 | 0.40 | 0.80 | 0.00 | 0.00 |
PWID who are on OST | 0.00 | 0.00 | 0.80 | 0.40 | 0.80 | 0.80 | 0.80 |
Fraction of PWID with OST access | 0.13 | 0.80 | 0.13 | 0.13 | 0.13 | 0.80 | 0.80 |
HIV prevalence after 10 years | |||||||
Overall (%) | 0.57 | 0.56 | 0.56 | 0.57 | 0.57 | 0.56 | 0.56 |
Among PWID (%) | 16.52 | 14.26 | 15.84 | 15.96 | 16.16 | 14.14 | 14.23 |
Among non-PWID (%) | 0.51 | 0.50 | 0.50 | 0.50 | 0.50 | 0.50 | 0.50 |
HIV infections averted over 10 yr | |||||||
Total | - | 60,986 | 28,862 | 21,991 | 19,229 | 74,426 | 70,547 |
Among PWID | - | 24,926 | 10,949 | 8,593 | 7,143 | 28,895 | 27,807 |
Among non-PWID | - | 36,060 | 17,913 | 13,398 | 12,086 | 45,531 | 42,741 |
Total receiving ART | 552,650 | 599,110 | 545,870 | 547,960 | 546,210 | 568,910 | 569,280 |
Incremental Costs (US$ billions) | - | 55.5 | 60.7 | 56.8 | 57.8 | 92.4 | 92.0 |
Incremental QALYs (millions) | - | 2.3 | 7.8 | 6.8 | 7.5 | 8.7 | 8.5 |
ICER ($/QALY) | - | 24,072 | 7,777 | 8,299 | 7,707 | Dominated | Dominated |
* Under the status quo, the total cost is 40,439 (US$ billions) and the total QALYs is 5270 (millions). For the other strategies, incremental costs and QALYs are relative to the status quo.
HIV: human immunodeficiency virus; PWID: people who inject drugs; OST: opioid substitution therapy; ART: antiretroviral therapy; QALY: quality-adjusted life year; ICER: incremental cost-effectiveness ratio relative to status quo.