Cost-effectiveness of a post-exposure HIV chemoprophylaxis program for blood exposures in health care workers.
We performed a cost-effectiveness analysis of a post-exposure chemoprophylaxis program for health care workers who sustained exposures to blood. We analyzed a program of (1) treatment with zidovudine alone versus no treatment and (2) treatment with three-drug therapy versus no treatment. Assuming that 35% of exposures were to HIV-positive sources, the zidovudine regimen prevented 53 HIV seroconversions per 100,000 exposures, at a societal cost of $2.0 million per case of HIV prevented. The cost per quality-adjusted life year saved was $175,222. A three-drug chemoprophylactic therapy program (postulating 100% effectiveness and 35% source HIV positivity), prevented 66 seroconversions per 100,000 exposures, at a cost of $2.1 million per case of HIV prevented and $190,392 per quality-adjusted life year saved. Treating sources known to be HIV-positive and treating severe exposures were the most cost-effective strategies.
Marin
M G
MG
UMD-New Jersey Medical School, Newark 07103, USA.
Van Lieu
J
J
Yee
A
A
Bonner
E
E
Glied
S
S
D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000517:prevention & control*; D017048:Health Care Costs; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008875:Middle Aged; D017059:Models, Econometric; D009515:New Jersey; D019057:Quality-Adjusted Life Years; D015215:Zidovudine / Q000191:economics / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D015215:Zidovudine