|
Sign In to gain access to subscriptions and/or personal tools.
|
Threshold Analysis and Programs for Prevention of HIV Infection
David R. Holtgrave, PhD
Noreen L. Qualls, DrPH, MSPH
Background. Measuring the economic effectiveness of HIV-infection prevention activities poses special challenges in terms of behavioral change and health outcomes assessment. Methods. One way to address this difficulty is to employ threshold analysis to determine a level of cost per HIV infection averted above which society would seem unwilling to pay. The authors employ a cost-utility analytic framework to determine a monetary threshold for HIV prevention programs, subject base-case results to sensitivity analyses, and apply these results to the Centers for Disease Control and Prevention's fiscal year 1993 budget for extramural HIV prevention programs. Results. The monetary threshold for cost per HIV infection averted was calculated to be $417,000 in 1993 dollars, and ranged from $185,000 to $648,000 depending upon the dollar amount society would be willing to pay per quality- adjusted life year gained. Conclusions. Economic evaluations of particular HIV-infection prevention activities at least can begin by determining whether their levels of effectiveness are above or below this derived monetary threshold, and refinements beyond this dichoto mous evaluation can proceed as further data become available. Key words: HIV; AIDS; prevention; threshold analysis; cost-utility analysis. (Med Decis Making 1995;15:311-317)
Medical Decision Making, Vol. 15, No. 4,
311-317 (1995)
DOI: 10.1177/0272989X9501500402
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
S. M. Shechter, M. D. Bailey, A. J. Schaefer, and M. S. Roberts
The Optimal Time to Initiate HIV Therapy Under Ordered Health States
Operations Research,
January 1, 2008;
56(1):
20 - 33.
[Abstract]
[PDF]
|
|
|
|
|
|
|
T. O. Tengs and T. H. Lin
A Meta-Analysis of Utility Estimates for HIV/AIDS
Med Decis Making,
December 1, 2002;
22(6):
475 - 481.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. C. Weinstein, S. J. Goldie, E. Losina, C. J. Cohen, J. D. Baxter, H. Zhang, A. D. Kimmel, and K. A. Freedberg
Use of Genotypic Resistance Testing To Guide HIV Therapy: Clinical Impact and Cost-Effectiveness
Ann Intern Med,
March 20, 2001;
134(6):
440 - 450.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. H. Kaplan
Implicit Valuation of a Blood-exclusion Decision
Med Decis Making,
April 1, 1999;
19(2):
207 - 213.
[Abstract]
[PDF]
|
|
|
|
|
|
|
E. H. Kaplan and R. Brookmeyer
Snapshot Estimators of Recent HIV Incidence Rates
Operations Research,
January 1, 1999;
47(1):
29 - 37.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. D. Paltiel and K. A. Freedberg
The Cost-Effectiveness of Preventing Cytomegalovirus Disease in AIDS Patients
Interfaces,
May 1, 1998;
28(3):
34 - 51.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. D. Paltiel, J. A. Scharfstein, G. R. Seage, E. Losina, S. J. Goldie, M. C. Weinstein, D. E. Craven, and K. A. Freedberg
A Monte Carlo Simulation of Advanced HIV Disease: Application to Prevention of CMV Infection
Med Decis Making,
April 1, 1998;
18(2):
S93 - S105.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. A. Scharfstein, A. D. Paltiel, and K. A. Freedberg
The Cost-Effectiveness of Fluconazole Prophylaxis against Primary Systemic Fungal Infections in AIDS Patients
Med Decis Making,
October 1, 1997;
17(4):
373 - 381.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. D. Pinkerton, D. R. Holtgrave, and H. J. Pinkerton
Cost-effectiveness of Chemoprophylaxis After Occupational Exposure to HIV
Arch Intern Med,
September 22, 1997;
157(17):
1972 - 1980.
[Abstract]
[PDF]
|
|
|
|
|
