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HIV Cost-effectiveness

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Cost-Effectiveness Databases

  • Tufts Medical Center Cost-Effectiveness Analysis Registry

(https://research.tufts-nemc.org/cear4/)

This US-based database offers detailed information on more than 2,500 English-language cost-effectiveness analyses published in the peer-reviewed medical and economic literature.  The original cost per QALY estimates from a wide array of diseases and intervention types are retrieved and updated to the most recent year for comparison purposes.

  • National Institute for Health and Clinical Excellence (NICE)

(http://www.nice.org.uk/)

NICE serves the United Kingdom’s National Health Services and is well-known for developing and publishing guidelines on public health, health technologies and clinical practice based on evaluations of efficacy and cost-effectiveness evidence. It also sets quality standards and manages a national database for high-quality, cost-effective patient care, covering the treatment and prevention of different diseases and conditions. NICE provides access to quality information and best practices so that care decisions can be made based on the best possible evidence.

  • NHS Economic Evaluation Database (EED)

(http://www.crd.york.ac.uk/crdweb/HomePage.asp)

This UK-based database focuses on the economic evaluation of health care interventions, including cost-benefit analyses, cost-utility analyses, and cost-effectiveness analyses. Extensive literature searches are undertaken each week, and brief details from eligible studies are published on the database. Studies that are relevant to the UK health care system are considered priorities for writing abstracts, which include a non-technical summary of the topic, conclusions, and a brief description of the effectiveness information. A critical commentary summarizes the overall reliability and generalizability of the study.

Cost Inflation Tool

Consumer Price Index (CPI)
The Consumer Price Index (CPI) is a measure of the average change over time in the prices paid by urban consumers for a market basket of consumer goods and services. Every month the Bureau of Labor Statistics (BLS) surveys prices and generates the CPI. The CPI includes all consumer expenditure items in more than 200 categories, arranged into eight major CPI components, such as housing, transportation, medical care, etc. Researchers often use the medical care component of the CPI to adjust health care costs reported in previous years to their value in current dollars.

Historic CPI series and component data can be found at the Bureau of Labor Statistics website: http://www.bls.gov/cpi/.

How to adjust medical costs using CPI
The formula for calculating current costs using the CPI is relatively simple. Assume the medical care component of CPI for year 1990 is 125. A CPI for year 2000 of 175 indicates a 1.4 cost adjustment or a 40% increase in medical-related expenditures since 1990.

Year Medical care component of CPI Inflation rate from
year 1 to year 5
1990 125 175/125=1.4
2000 175

Assume the medical costs for condition X are estimated to be $10,000 per patient in year 1990. By multiplying $10,000 by 1.4, we get the value of the medical costs for condition X in 2000. In other words, treatment valued at $10,000 in 1990 would cost $14,000 in 2000.

Additional Prevention Modeling and Economics Team (PMET) Publications

  1. Prabhu VS, Farnham PG, Hutchinson AB, Soorapanth S, Heffelfinger JD, Golden MR, Brooks JT, Rimland D, Sansom SL. Cost-effectiveness of HIV screening in STD clinics, emergency departments, and inpatient units: a model-based analysis. PLoS One 2011; 6(5): e19936.
  2. Hutchinson AB, P. Patel, S. L. Sansom, P. G. Farnham, T. J. Sullivan, B. Bennett, P. R. Kerndt, R. K. Bolan, J. D. Heffelfinger, V. S. Prabhu, and B. M. Branson. Cost-effectiveness of pooled nucleic acid amplification testing for acute HIV infection after third-generation HIV antibody screening and rapid testing in the United States: a comparison of three public health settings. PLoS Med 2010; 7: e1000342.
  3. Prabhu VS, Hutchinson AB, Farnham PG, Sansom SL.  Sexually acquired infections in the United States due to acute-phase HIV transmission: an update. AIDS 2009;23(13): 1792-1794.
  4. Sansom SL, Hutchinson AB, An Q, Hall I, Shrestha RK, Prabhu VS, Lasry A, Taylor A. Cost-effectiveness of newborn circumcision in preventing HIV among U.S. males. PLoS One 2010; 5(1): e8723.
  5. Hutchinson AB, Farnham PG, Duffy N, Wolitski RJ, Sansom SL, Dooley SW, Cleveland JC, Mermin JH. Return on public health investment: CDC’s expanded HIV testing initiative. JAIDS 2011 (Epub ahead of print).

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