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Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India

BACKGROUND: Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. METHODS: Based on data f...

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Autores principales: Dandona, Lalit, Kumar, SG Prem, Kumar, G Anil, Dandona, Rakhi
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874552/
https://www.ncbi.nlm.nih.gov/pubmed/20459755
http://dx.doi.org/10.1186/1472-6963-10-117
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author Dandona, Lalit
Kumar, SG Prem
Kumar, G Anil
Dandona, Rakhi
author_facet Dandona, Lalit
Kumar, SG Prem
Kumar, G Anil
Dandona, Rakhi
author_sort Dandona, Lalit
collection PubMed
description BACKGROUND: Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. METHODS: Based on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY) saved as a measure of cost-effectiveness of each type of HIV prevention intervention. RESULTS: The point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions. CONCLUSIONS: The point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India.
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spelling pubmed-28745522010-05-22 Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India Dandona, Lalit Kumar, SG Prem Kumar, G Anil Dandona, Rakhi BMC Health Serv Res Research article BACKGROUND: Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. METHODS: Based on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY) saved as a measure of cost-effectiveness of each type of HIV prevention intervention. RESULTS: The point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions. CONCLUSIONS: The point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India. BioMed Central 2010-05-10 /pmc/articles/PMC2874552/ /pubmed/20459755 http://dx.doi.org/10.1186/1472-6963-10-117 Text en Copyright ©2010 Dandona et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research article
Dandona, Lalit
Kumar, SG Prem
Kumar, G Anil
Dandona, Rakhi
Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India
title Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India
title_full Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India
title_fullStr Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India
title_full_unstemmed Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India
title_short Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India
title_sort cost-effectiveness of hiv prevention interventions in andhra pradesh state of india
topic Research article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874552/
https://www.ncbi.nlm.nih.gov/pubmed/20459755
http://dx.doi.org/10.1186/1472-6963-10-117
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