Cost-per-diagnosis as a metric for monitoring cost-effectiveness of HIV testing programmes in low-income settings in southern Africa: health economic and modelling analysis

By Andrew N Phillips, Valentina Cambiano, Fumiyo Nakagawa, Loveleen Bansi-Matharu, David Wilson, Ilesh Jani, Tsitsi Apollo, Mark Sculpher, Timothy Hallett, Cliff Kerr, Joep J van Oosterhout, Jeffrey W Eaton, Janne Estill, Brian Williams12, Naoko Doi, Frances Cowan, Olivia Keiser, Deborah Ford, Karin Hatzold, Ruanne Barnabas, Helen Ayles  Lisa Nelson, Cheryl Johnson, Rachel Baggaley, Ade Fakoya, Andreas Jahn and Paul Revill  |  | 

The paper investigates the use of “cost per new HIV diagnosis” as a metric of the cost effectiveness of new HIV testing strategies, in contrast to more commonly used metrics, for two packages of testing modalities across several southern African countries. We found a very strong relationship between cost-per-diagnosis and cost-per-DALY-averted, with incremental cost-effectiveness ratios being below $500 per-DALY-averted as long as the cost-per-diagnosis was below $315. Across modalities and settings, additional testing of women appeared much less cost effective than additional testing of men.

Publication details

Journal of the International AIDS Society