Comparative analyses of published cost effectiveness models highlight critical considerations which are useful to inform development of new models

Figures & data

Table 1. Weinstein and Sendi’s utility values according to CD4 count +/− AIDS status and VL.

Parameters	Utility	Model
CD4 Stratum (cells/µL)
0–200 (no AIDS)	0.739	Sendi
50–100	0.81	Weinstein
100–200	0.87	Weinstein
201–500 (no AIDS)	0.78	Sendi^a
>200	0.94	Weinstein
≥500 (no AIDS)	0.801	Sendi^a
Viral Load
Undetectable viral load (first 2 years)	0.79	Sendi^a
Detectable viral load (<2 years)	0.755	Sendi^a

^aSendi also included the disutility for a detectable VL (>2 years)=0.035 [37] and disutility of an AIDS indicator disease = 0.233.

Figure 1. Standardized incremental cost effectiveness ratios (2018 USD). Author, study (if relevant), perspective, cost discount rate, outcome discount rate, output measure. HP, healthcare payer (public); MS, modified societal; S, societal. Phillips results not directly comparable because results are reported as total (2015–2025) incremental cost of $191.1m per 139,589 Disability Adjusted Life Years (DALYs) averted over ten years compared to a no monitoring strategy (discounted at 3.5%) (Phillips 2014 referencing Figure 2)²⁵.

Zinkernagel C, Ledergerber B, Battegay M, et al. Quality of life in asymptomatic patients with early HIV infection initiating antiretroviral therapy. Swiss HIV Cohort Study. Aids. 1999;13(12):1587–1589.

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Phillips A, Cambiano V, Nakagawa F, et al. Cost-effectiveness of HIV drug resistance testing to inform switching to second line antiretroviral therapy in low income settings. PLoS One. 2014;9(10):e109148.

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