Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review
Abstract Background Continuing progress in the global pediatric human immunodeficiency virus (HIV) response depends on timely identification and care of infants with HIV. As countries scale-out improvements to HIV early infant diagnosis (EID), economic evaluations are needed to inform program design...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Infectious Diseases of Poverty |
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| Online Access: | https://doi.org/10.1186/s40249-022-01006-7 |
| _version_ | 1818474118764298240 |
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| author | Kira Elsbernd Karl M. F. Emmert-Fees Amanda Erbe Veronica Ottobrino Arne Kroidl Till Bärnighausen Benjamin P. Geisler Stefan Kohler |
| author_facet | Kira Elsbernd Karl M. F. Emmert-Fees Amanda Erbe Veronica Ottobrino Arne Kroidl Till Bärnighausen Benjamin P. Geisler Stefan Kohler |
| author_sort | Kira Elsbernd |
| collection | DOAJ |
| description | Abstract Background Continuing progress in the global pediatric human immunodeficiency virus (HIV) response depends on timely identification and care of infants with HIV. As countries scale-out improvements to HIV early infant diagnosis (EID), economic evaluations are needed to inform program design and implementation. This scoping review aimed to summarize the available evidence and discuss practical implications of cost and cost-effectiveness analyses of HIV EID. Methods We systematically searched bibliographic databases (Embase, MEDLINE and EconLit) and grey literature for economic analyses of HIV EID in low- and middle-income countries published between January 2008 and June 2021. We extracted data on unit costs, cost savings, and incremental cost-effectiveness ratios as well as outcomes related to health and the HIV EID care process and summarized results in narrative and tabular formats. We converted unit costs to 2021 USD for easier comparison of costs across studies. Results After title and abstract screening of 1278 records and full-text review of 99 records, we included 29 studies: 17 cost analyses and 12 model-based cost-effectiveness analyses. Unit costs were 21.46–51.80 USD for point-of-care EID tests and 16.21–42.73 USD for laboratory-based EID tests. All cost-effectiveness analyses stated at least one of the interventions evaluated to be cost-effective. Most studies reported costs of EID testing strategies; however, few studies assessed the same intervention or reported costs in the same way, making comparison of costs across studies challenging. Limited data availability of context-appropriate costs and outcomes of children with HIV as well as structural heterogeneity of cost-effectiveness modelling studies limits generalizability of economic analyses of HIV EID. Conclusions The available cost and cost-effectiveness evidence for EID of HIV, while not directly comparable across studies, covers a broad range of interventions and suggests most interventions designed to improve EID are cost-effective or cost-saving. Further studies capturing costs and benefits of EID services as they are delivered in real-world settings are needed. Graphical Abstract |
| first_indexed | 2024-04-14T04:32:28Z |
| format | Article |
| id | doaj.art-1678d866895a45c68136bbe8063c2ed7 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-04-14T04:32:28Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-1678d866895a45c68136bbe8063c2ed72022-12-22T02:11:59ZengBMCInfectious Diseases of Poverty2049-99572022-07-0111112010.1186/s40249-022-01006-7Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping reviewKira Elsbernd0Karl M. F. Emmert-Fees1Amanda Erbe2Veronica Ottobrino3Arne Kroidl4Till Bärnighausen5Benjamin P. Geisler6Stefan Kohler7Division of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Ludwig Maximilians UniversityDepartment of Sports and Health Sciences, Technical University of MunichHeidelberg Institute of Global Health, Heidelberg UniversityHeidelberg Institute of Global Health, Heidelberg UniversityDivision of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Ludwig Maximilians UniversityHeidelberg Institute of Global Health, Heidelberg UniversityInstitute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig Maximilian UniversityHeidelberg Institute of Global Health, Heidelberg UniversityAbstract Background Continuing progress in the global pediatric human immunodeficiency virus (HIV) response depends on timely identification and care of infants with HIV. As countries scale-out improvements to HIV early infant diagnosis (EID), economic evaluations are needed to inform program design and implementation. This scoping review aimed to summarize the available evidence and discuss practical implications of cost and cost-effectiveness analyses of HIV EID. Methods We systematically searched bibliographic databases (Embase, MEDLINE and EconLit) and grey literature for economic analyses of HIV EID in low- and middle-income countries published between January 2008 and June 2021. We extracted data on unit costs, cost savings, and incremental cost-effectiveness ratios as well as outcomes related to health and the HIV EID care process and summarized results in narrative and tabular formats. We converted unit costs to 2021 USD for easier comparison of costs across studies. Results After title and abstract screening of 1278 records and full-text review of 99 records, we included 29 studies: 17 cost analyses and 12 model-based cost-effectiveness analyses. Unit costs were 21.46–51.80 USD for point-of-care EID tests and 16.21–42.73 USD for laboratory-based EID tests. All cost-effectiveness analyses stated at least one of the interventions evaluated to be cost-effective. Most studies reported costs of EID testing strategies; however, few studies assessed the same intervention or reported costs in the same way, making comparison of costs across studies challenging. Limited data availability of context-appropriate costs and outcomes of children with HIV as well as structural heterogeneity of cost-effectiveness modelling studies limits generalizability of economic analyses of HIV EID. Conclusions The available cost and cost-effectiveness evidence for EID of HIV, while not directly comparable across studies, covers a broad range of interventions and suggests most interventions designed to improve EID are cost-effective or cost-saving. Further studies capturing costs and benefits of EID services as they are delivered in real-world settings are needed. Graphical Abstracthttps://doi.org/10.1186/s40249-022-01006-7Cost effectivenessDiagnosticsLow- and middle-income countriesPoint of careEarly infant diagnosisHealth systems |
| spellingShingle | Kira Elsbernd Karl M. F. Emmert-Fees Amanda Erbe Veronica Ottobrino Arne Kroidl Till Bärnighausen Benjamin P. Geisler Stefan Kohler Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review Infectious Diseases of Poverty Cost effectiveness Diagnostics Low- and middle-income countries Point of care Early infant diagnosis Health systems |
| title | Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review |
| title_full | Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review |
| title_fullStr | Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review |
| title_full_unstemmed | Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review |
| title_short | Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review |
| title_sort | costs and cost effectiveness of hiv early infant diagnosis in low and middle income countries a scoping review |
| topic | Cost effectiveness Diagnostics Low- and middle-income countries Point of care Early infant diagnosis Health systems |
| url | https://doi.org/10.1186/s40249-022-01006-7 |
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