AEGiS-11IAC: The economic impact of treatment of HIV-positive women and their newborns with zidovudine: implications for HIV screening.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

The economic impact of treatment of HIV-positive women and their newborns with zidovudine: implications for HIV screening.

Int Conf AIDS 1996 Jul 7-12; 11:31 (abstract no. LB.B.6047)
Mauskopf J, Paul J, White A, Tilson H; Glaxo Wellcome Inc., Research Triangle Park, NC. Fax: (919) 483-3096. E-mail: JAM18448@GLAXO.COM.

OBJECTIVES: To estimate the economic and health impacts of (1) treating pregnant women who are human immunodeficiency virus (HIV)-positive with zidovudine and (2) voluntary HIV screening programs for pregnant women.

METHODS: Health care costs and reduced cases of pediatric HIV infection were estimated. Health care costs estimated include the cost of zidovudine and its administration as well as costs of treating pediatric HIV infection. Estimates of the reduction in maternal-to-fetal transmission rates with zidovudine are taken from the ACTG 076 trial. Costs for a voluntary screening program include costs of screening tests and counseling. Sensitivity and threshold analyses are performed to determine the impact of changes in input parameter values on the estimated costs and benefits.

RESULTS: Assuming transmission rates are reduced from 25.5% to 8.3% as found in the ACTG 076 rial, treatment costs of $104,502 for 100 HIV-positive pregnant women and their newborns are offset by a reduction of $1,701,333 associated with fewer cases of pediatric HIV infection in the base case. Sensitivity analysis shows that overall cost savings from treatment are achieved for a wide range of possible efficacy rates and maternal and pediatric treatment costs. In the base case analysis for the voluntary screening program, overall cost savings are seen when the HIV prevalence rate among pregnant women is greater than 4.6 per 1,000. However this threshold value is sensitive to changes in input parameter values, especially pediatric HIV treatment costs, counseling costs, efficacy of treatment, and years of additional treatment for the pregnant women.

CONCLUSION: Offering zidovudine treatment to HIV-positive pregnant women decreases the number of cases of pediatric HIV infection and reduces health care costs. Voluntary screening programs for pregnant women will further decrease the number of cases of pediatric HIV-infection. The net costs for a voluntary screening program vary with HIV prevalence and the costs of the program.

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