Cost-effectiveness of HIV interventions: from cohort studies and clinical trials to policy

Incremental cost-effectiveness ratios quantify the additional cost of an intervention relative to the additional benefit associated with its use. Whether an intervention is considered cost-effective depends largely on policy decisions regarding whether the additional benefit is worth the additional cost in the context of competing needs for resources. In the United States, costeffectiveness analyses have been instrumental in guiding changes in HIV policy supporting antiretroviral therapy, genotypic resistance testing, and expanded programs for HIV screening. The cost-effectiveness of HIV screening compares favorably with that of accepted screening practices for other chronic diseases. This article is a summary of a presentation made by Rochelle P. Walensky, MD, MPH, at the International AIDS Society-USA Chicago program held in May 2009. The original presentation is available as a Webcast at www.iasusa.org.