Economic and health implications from earlier detection of HIV infection in the United Kingdom

Vladimir Zah,1,2 Mondher Toumi1 1Ecole Doctoral Interdisciplinaire Sciences-Santé (EDISS), University of Lyon, Lyon, France; 2ZRx Outcomes Research Inc., Mississauga, Canada Purpose: To model the budget and survival impact of implementing interventions to increase the proportion of HIV i...

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Autores principales:	Zah V, Toumi M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	HIV testing costs savings model Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/f04e045b7d8049ee9e1fabb484b139b8
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spelling	oai:doaj.org-article:f04e045b7d8049ee9e1fabb484b139b82021-12-02T02:42:21ZEconomic and health implications from earlier detection of HIV infection in the United Kingdom1179-1373https://doaj.org/article/f04e045b7d8049ee9e1fabb484b139b82016-03-01T00:00:00Zhttps://www.dovepress.com/economic-and-health-implications-from-earlier-detection-of-hiv-infecti-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Vladimir Zah,1,2 Mondher Toumi1 1Ecole Doctoral Interdisciplinaire Sciences-Santé (EDISS), University of Lyon, Lyon, France; 2ZRx Outcomes Research Inc., Mississauga, Canada Purpose: To model the budget and survival impact of implementing interventions to increase the proportion of HIV infections detected early in a given UK population. Patients and methods: A Microsoft Excel decision model was designed to generate a set of outcomes for a defined population. Survival was modeled on the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study extrapolated to a 5-year horizon as a constant hazard. Hazard rates were specific to age, sex, and whether detection was early or late. The primary outcomes for each year up to 5 years were: annual costs, numbers of infected cases, hospital admissions, and surviving cases. Three locations in the UK were chosen to model outcomes across a range of HIV prevalence areas: Lambeth, Southwark, and Lewisham (LSL), Greater Manchester Cluster (GMC), and Kent and Medway (K&M). Results: In LSL, the projected cumulative cost savings over 5 years were £3,210,206 or £5,290,206 when including the value of the 104 life-years saved. Savings were insensitive to transmission rates, but sensitive in direct proportion to the percentage shift from late to early detection. In GMC, savings were in a similar proportion to LSL, but the magnitude was smaller, as a consequence of the lower base-case HIV prevalence. In K&M, with a smaller population and lower HIV prevalence than GMC, savings were commensurately smaller (£733,202 cumulatively over 5 years). Conclusion: The results strengthen the rationale for implementing increased testing in high prevalence areas. However, in areas of low prevalence, it is unlikely that costs will be returned over a 5-year period. Keywords: HIV, testing, costs, savings, modelZah VToumi MDove Medical PressarticleHIVtestingcostssavingsmodelImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2016, Iss Issue 1, Pp 67-74 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	HIV testing costs savings model Immunologic diseases. Allergy RC581-607
spellingShingle	HIV testing costs savings model Immunologic diseases. Allergy RC581-607 Zah V Toumi M Economic and health implications from earlier detection of HIV infection in the United Kingdom
description	Vladimir Zah,1,2 Mondher Toumi1 1Ecole Doctoral Interdisciplinaire Sciences-Santé (EDISS), University of Lyon, Lyon, France; 2ZRx Outcomes Research Inc., Mississauga, Canada Purpose: To model the budget and survival impact of implementing interventions to increase the proportion of HIV infections detected early in a given UK population. Patients and methods: A Microsoft Excel decision model was designed to generate a set of outcomes for a defined population. Survival was modeled on the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study extrapolated to a 5-year horizon as a constant hazard. Hazard rates were specific to age, sex, and whether detection was early or late. The primary outcomes for each year up to 5 years were: annual costs, numbers of infected cases, hospital admissions, and surviving cases. Three locations in the UK were chosen to model outcomes across a range of HIV prevalence areas: Lambeth, Southwark, and Lewisham (LSL), Greater Manchester Cluster (GMC), and Kent and Medway (K&M). Results: In LSL, the projected cumulative cost savings over 5 years were £3,210,206 or £5,290,206 when including the value of the 104 life-years saved. Savings were insensitive to transmission rates, but sensitive in direct proportion to the percentage shift from late to early detection. In GMC, savings were in a similar proportion to LSL, but the magnitude was smaller, as a consequence of the lower base-case HIV prevalence. In K&M, with a smaller population and lower HIV prevalence than GMC, savings were commensurately smaller (£733,202 cumulatively over 5 years). Conclusion: The results strengthen the rationale for implementing increased testing in high prevalence areas. However, in areas of low prevalence, it is unlikely that costs will be returned over a 5-year period. Keywords: HIV, testing, costs, savings, model
format	article
author	Zah V Toumi M
author_facet	Zah V Toumi M
author_sort	Zah V
title	Economic and health implications from earlier detection of HIV infection in the United Kingdom
title_short	Economic and health implications from earlier detection of HIV infection in the United Kingdom
title_full	Economic and health implications from earlier detection of HIV infection in the United Kingdom
title_fullStr	Economic and health implications from earlier detection of HIV infection in the United Kingdom
title_full_unstemmed	Economic and health implications from earlier detection of HIV infection in the United Kingdom
title_sort	economic and health implications from earlier detection of hiv infection in the united kingdom
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/f04e045b7d8049ee9e1fabb484b139b8
work_keys_str_mv	AT zahv economicandhealthimplicationsfromearlierdetectionofhivinfectionintheunitedkingdom AT toumim economicandhealthimplicationsfromearlierdetectionofhivinfectionintheunitedkingdom
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Economic and health implications from earlier detection of HIV infection in the United Kingdom

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