Table 3.
Incremental cost-effectiveness ratios (ICERs) of ART and PrEP strategies for southwest Uganda
| Outcome | Scenario | Effectiveness | Cost (millions USD) | ICER |
|---|---|---|---|---|
| HIV infections averted | Baseline: Current ART uptake ART: Baseline (40%)a PrEP: N/A |
94,000 | 185 | Baseline |
| ART scale up only (no PrEP) ART: CD4≤500 cells/µL (55%) PrEP: N/A |
104,000 (37%) | 200 | Dominatedb | |
| MoH adds PrEP programme for all high-risk serodiscordant couples ART: Baseline (40%)a+high-risk couplesc without CD4/VL criteria (80%) PrEP: High-risk couplesc (80%) |
120,000 (43%) | 219 | $1340 | |
| DALYs averted | Baseline: Current ART uptake ART: Baseline (40%)a PrEP: N/A |
203,000 | 185 | Baseline |
| ART scale up only (no PrEP) ART: CD4≤500 cells/µL (55%) PrEP: N/A |
217,000 (60%) | 200 | $1075 | |
| MoH adds PrEP programme for all high-risk serodiscordant couples ART: Baseline (40%)a+high-risk SDCc without CD4/VL criteria (80%) PrEP: High-risk couplesc (80%) |
221,000 (62%) | 219 | $5354 |
Results are shown for a 10-year time horizon relative to 2014
a
under former guidelines
b
extended dominance occurs when a strategy is less cost-effective than a combination of other strategies
c
high-risk serodiscordant couples are those in which the HIV-negative partner is ≤25 years old and both partners are in the top 15th percentile in the number of casual sexual partners.