Cost-effectiveness estimates for antenatal HIV testing in the Netherlands.

Area of Science:

• Public Health
• Health Economics
• Epidemiology

Background:

• Estimating lifetime healthcare costs for children with HIV is crucial for resource allocation.
• Assessing the cost-effectiveness of universal HIV screening in pregnant women informs public health policy.
• Previous data on HIV prevalence and treatment costs in the Netherlands require updates.

Purpose of the Study:

• To estimate the lifetime healthcare cost for children infected with HIV.
• To update the cost-effectiveness analysis of universal HIV screening among pregnant women in Amsterdam.
• To evaluate the health-economic justification of antenatal HIV screening programs.

Main Methods:

• Data collection on newly diagnosed HIV-infected pregnant women in Amsterdam (2003-2005).
• Gathering resource utilization and Highly Active Antiretroviral Therapy (HAART) regimen data from a national registry for HIV-infected children.
• Employing Kaplan-Meier survival analysis to estimate life expectancy and associated lifetime healthcare costs.

Main Results:

• Estimated life expectancy for a vertically HIV-infected child is 19 years.
• Estimated lifetime healthcare costs for an HIV-infected child are €179,974.
• Universal HIV screening could prevent approximately 2.4 HIV transmissions annually in Amsterdam, with an estimated prevalence of 9 undiagnosed HIV-positive pregnant women per 10,000 pregnancies.

Conclusions:

• Universal HIV screening during pregnancy yields significant net cost savings and health benefits.
• Antenatal HIV screening is a justifiable public health intervention from a health-economic perspective in Amsterdam.
• Implementing universal screening policies can reduce HIV transmission rates and long-term healthcare burdens.