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. 2019 Jan 17;19(1):64.
doi: 10.1186/s12879-019-3708-x.

Programmes for the prevention of mother-to-child HIV infection transmission have made progress in Yunnan Province, China, from 2006 to 2015: a cost effective and cost-benefit evaluation

Xiaowen Wang  1   2 , Guangping Guo  3 , Jiarui Zheng  3 , Lin Lu  4   5
Affiliations

Programmes for the prevention of mother-to-child HIV infection transmission have made progress in Yunnan Province, China, from 2006 to 2015: a cost effective and cost-benefit evaluation

Xiaowen Wang et al. BMC Infect Dis. .

Abstract

Background: Prevention of mother-to-child transmission (PMTCT) of HIV programmes have substantially reduced HIV infections among infants in Yunnan Province, China. We conducted a macro-level economic evaluation of Yunnan's PMTCT programmes over the 10 years from 2006 to 2015 from a policymaker perspective.

Methods: The study methodology was in accordance with the guidelines from the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. We quantified the output from the Yunnan's PMTCT programmes by estimating the number of paediatric HIV infections averted and the relative savings to both the health care system and society. The return-on-investment ratio (ROI) was calculated as the output (numerator) divided by the input (denominator).

Results: We have found that the US$ 49 million investment in Yunnan's PMTCT programmes over the period from 2006 to 2015 averted an estimated 2725 new paediatric HIV infections and resulted in an estimated 134,008 QALY acquired. It saved an estimated US$ 0.5 billion in treatment expenditures for Yunnan's healthcare system and nearly US$ 3.9 billion in productivity. The ROI was 88.4, meaning every US$ 1 invested brought about US$ 88.4 in benefits.

Conclusions: Our results support the ongoing investment in PMTCT programmes in Yunnan Province. The PMTCT strategy is a cost effective and cost-benefit strategy in the periods from 2006 to 2015. Despite higher investments in the future, the overall investment in the PMTCT programmes in Yunnan province could be offset by averting more paediatric infections.

Keywords: Cost benefit; Cost effective; Economic evaluation; Prevention mother-to-child transmission of HIV; Yunnan Province.

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Conflict of interest statement

Ethics approval and consent to participate

Because the study was based on aggregate data, ethical approval was not required. All data used in this study were obtained through approvals from Yunnan AIDS Prevention Bureau.

Consent for publication

Not applicable.

Competing interests

The authors declared that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a the sensitivity analysis of investment per pediatric HIV infection averted by changing HIV MTCT rate in the pre-PMTCT period. b the sensitivity analysis of investment per pediatric HIV infection averted by changing discount rate
Fig. 2
Fig. 2
a the sensitivity analysis of investment per investment per QALY acquired by changing HIV MTCT rate in the pre-PMTCT period. b the sensitivity analysis of investment per investment per QALY acquired by changing discount rate. c the sensitivity analysis of investment per investment per QALY acquired by changing life expectancy.
Fig. 3
Fig. 3
a the sensitivity analysis of ROI by changing HIV MTCT rate in the pre-PMTCT period. b the sensitivity analysis of ROI by changing discount rate. c the sensitivity analysis of ROI by changing life expectancy. d the sensitivity analysis of ROI by changing growth rate of GDP in Yunnan province
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