加强保留策略以防止乌干达的HIV垂直传播:预算影响分析
Elly Nuwamanya1,2, Benjamin C Johnson3, Stephen Okoboi4
1Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O Box 22418, Kampala, Uganda. enuwamanya@idi.co.ug.
PharmacoEconomics - open
|June 8, 2025
概括
在乌干达实施增强保留策略 (ERS) 增加了医疗保健成本,但避免了成千上万的婴儿艾滋病毒感染. 这一策略通过减少对随访的损失,改善了艾滋病毒感染妇女及其婴儿的结果.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 传染病流行病学 传染病流行病学
背景情况:
- 新的保留策略可以减少垂直艾滋病毒传播,并改善母亲和婴儿的健康结果.
- 估计增强保留策略 (ERS) 与标准护理 (SOC) 的预算影响对于预防乌干达开始抗逆转录病毒治疗 (ART) 的孕妇感染艾滋病毒至关重要.
研究的目的:
- 估计与SOC相比ERS的预算影响,以防止在乌干达怀孕晚期开始ART的妇女中垂直传播艾滋病毒.
- 从乌干达卫生部的角度来看,从五年时间内确定增加的成本和避免的感染.
主要方法:
- 从付款人的角度进行了5年预算影响分析 (BIA).
- 一个基于Microsoft Excel的BIA模型利用了艾滋病毒流行病学数据和来自文献和临床试验的支出.
- 预测包括计划性投入,疾病进展,基于治疗的死亡率差异和乌干达艾滋病毒阳性孕妇的随后怀孕.
主要成果:
- 与SOC相比,ERS的结果是5年内净成本增加6380万美元 (每年1270万美元),而SOC的净成本增加为6380万美元.
- 大多数增加的成本 (87%) 源于为留在护理中的妇女提供ART,而不是直接的程序性成本 (13%).
- 预计与SOC相比,ERS可以在5年内避免另外6933例婴儿艾滋病毒感染.
结论:
- 埃尔斯显著增加了乌干达卫生部的预算,主要是由于扩大了ART客户数量.
- 在边缘化和难以接触的人群中,ERS代表了一种具有成本效益的干预措施,以减少对随访率的损失.
- 该战略表明,医疗保健支出增加和婴儿艾滋病毒感染的大幅减少之间存在有利的平衡.
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