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- Title
Potential Impact and Cost-effectiveness of Self-Testing for HIV in Low-Income Countries.
- Authors
Cambiano, Valentina; Ford, Deborah; Mabugu, Travor; Mavedzenge, Sue Napierala; Miners, Alec; Mugurungi, Owen; Nakagawa, Fumiyo; Revill, Paul; Phillips, Andrew
- Abstract
Background. Studies have demonstrated that self-testing for human immunodeficiency virus (HIV) is highly acceptable among individuals and could allow cost savings, compared with provider-delivered HIV testing and counseling (PHTC), although the longer-term population-level effects are uncertain. We evaluated the cost-effectiveness of introducing self-testing in 2015 over a 20-year time frame in a country such as Zimbabwe. Methods. The HIV synthesis model was used. Two scenarios were considered. In the reference scenario, selftesting is not available, and the rate of first-time and repeat PHTC is assumed to increase from 2015 onward, in line with past trends. In the intervention scenario, self-testing is introduced at a unit cost of $3. Results. We predict that the introduction of self-testing would lead to modest savings in healthcare costs of $75 million, while averting around 7000 disability-adjusted life-years over 20 years. Findings were robust to most variations in assumptions; however, higher cost of self-testing, lower linkage to care for people whose diagnosis is a consequence of a positive self-test result, and lower threshold for antiretroviral therapy eligibility criteria could lead to situations in which self-testing is not cost-effective. Conclusions. This analysis suggests that introducing self-testing offers some health benefits and may well save costs.
- Subjects
PATIENT self-monitoring; HIV-positive persons; DIAGNOSIS of HIV infections; COST effectiveness; LOW-income countries; MEDICAL care cost control
- Publication
Journal of Infectious Diseases, 2015, Vol 212, Issue 4, p513
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jiv040