Comparison of economic and health implications from earlier detection of HIV infection in the United Kingdom and Poland

Comparison of economic and health implications from earlier detection of HIV infection in the United Kingdom and Poland

2015 Przegl Epidemiol

Zah, V. | Toumi, M. | Volume: 69, Issue: 4, Pages: 765-72, 899-903, AIDS Serodiagnosis/*economics/statistics & numerical data, Clinical Laboratory Techniques/economics, Cost-Benefit Analysis, Female, HIV Infections/*diagnosis/*economics/epidemiology, Health Care Costs/*trends, Humans, Male, Mass Screening/economics, National Health Programs/*economics, Poland, Quality-Adjusted Life Years, United Kingdom,

PURPOSE: To model the financial and survival impact of early HIV infection detection versus late and compare results between the UK and Polish setting among the newly detected patients. PATIENTS AND METHODS: A Microsoft Excel decision model (SUNRISE) was designed to generate a set of outcomes for a defined population. Survival was modelled on the COHERE study extrapolated to a 5-year horizon as a constant hazard. Hazard rates were specific to age, sex and whether detection was early or late. The primary outcomes for each year up to 5 years were: annual costs, numbers of infected cases, hospital admissions and surviving cases. Total population was observed in UK and Poland. ISPOR Budget Impact Model – Principles of Good Practice were utilised in SUNRISE development. RESULTS: The projected cumulative cost-savings over 5 years in Poland and UK were 5,823,479 PLN ( pound1,109,234) and pound21,608,562 respectfully. When including the value of life-years saved projected cumulative cost-savings in Poland and UK amounted to 8,374,018 PLN ( pound1,595,051) and pound29,834,679 respectively. Savings were insensitive to transmission rates, but were sensitive in direct proportion to the percentage shift from late to early detection. In UK, savings were in higher proportion to Poland, due to much higher overall cost of HIV treatment (whether early or late HIV detected patient). CONCLUSION: Estimated cost savings that could be translated into identification of appropriate programmes (providing wider coverage of HIV testing, awareness building) that would lead towards higher proportion of early HIV detected patients are very sensitive to the cost of HIV test and overall HIV treatment cost.