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. 2015 Jul 20;18(4Suppl 3):20527. doi: 10.7448/IAS.18.4.20527

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.