Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya
Abstract Objective This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. Methods A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryother...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | Cost Effectiveness and Resource Allocation |
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| Online Access: | http://link.springer.com/article/10.1186/s12962-017-0075-6 |
| _version_ | 1828462860184846336 |
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| author | Marita R. Zimmermann Elisabeth Vodicka Joseph B. Babigumira Timothy Okech Nelly Mugo Samah Sakr Louis P. Garrison Michael H. Chung |
| author_facet | Marita R. Zimmermann Elisabeth Vodicka Joseph B. Babigumira Timothy Okech Nelly Mugo Samah Sakr Louis P. Garrison Michael H. Chung |
| author_sort | Marita R. Zimmermann |
| collection | DOAJ |
| description | Abstract Objective This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. Methods A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryotherapy without screening, visual inspection with acetic acid (VIA), Papanicolaou smear (Pap), and testing for human papillomavirus (HPV). Direct and indirect medical and non-medical costs were examined from societal and clinic perspectives. Results Costs of cryotherapy, VIA, Pap, and HPV for women with CD4 200–500 cells/mL were $99, $196, $219, and $223 from a societal perspective and $19, $94, $124, and $113 from a clinic perspective, with 17.3, 17.1, 17.1, and 17.1 years of life expectancy, respectively. Women at higher CD4 counts (>500 cells/mL) given cryotherapy VIA, Pap, and HPV resulted in better life expectancies (19.9+ years) and lower cost (societal: $49, $99, $115, and $102; clinic: $13, $51, $71, and $56). VIA was less expensive than HPV unless HPV screening could be reduced to a single visit. Conclusions Preventative cryotherapy was the least expensive strategy and resulted in highest projected life expectancy, while VIA was most cost-effective unless HPV could be reduced to a single visit. |
| first_indexed | 2024-12-11T02:43:29Z |
| format | Article |
| id | doaj.art-2562772cf29a42e38040dd5addad696d |
| institution | Directory Open Access Journal |
| issn | 1478-7547 |
| language | English |
| last_indexed | 2024-12-11T02:43:29Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Cost Effectiveness and Resource Allocation |
| spelling | doaj.art-2562772cf29a42e38040dd5addad696d2022-12-22T01:23:29ZengBMCCost Effectiveness and Resource Allocation1478-75472017-07-0115111010.1186/s12962-017-0075-6Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in KenyaMarita R. Zimmermann0Elisabeth Vodicka1Joseph B. Babigumira2Timothy Okech3Nelly Mugo4Samah Sakr5Louis P. Garrison6Michael H. Chung7Department of Pharmacy, University of WashingtonDepartment of Pharmacy, University of WashingtonDepartment of Global Health, University of WashingtonChandaria School of Business, United States International University-AfricaDepartment of Obstetrics and Gynecology, Kenyatta National HospitalCoptic Hospital, Coptic Hope CenterDepartment of Pharmacy, University of WashingtonDepartment of Global Health, University of WashingtonAbstract Objective This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. Methods A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryotherapy without screening, visual inspection with acetic acid (VIA), Papanicolaou smear (Pap), and testing for human papillomavirus (HPV). Direct and indirect medical and non-medical costs were examined from societal and clinic perspectives. Results Costs of cryotherapy, VIA, Pap, and HPV for women with CD4 200–500 cells/mL were $99, $196, $219, and $223 from a societal perspective and $19, $94, $124, and $113 from a clinic perspective, with 17.3, 17.1, 17.1, and 17.1 years of life expectancy, respectively. Women at higher CD4 counts (>500 cells/mL) given cryotherapy VIA, Pap, and HPV resulted in better life expectancies (19.9+ years) and lower cost (societal: $49, $99, $115, and $102; clinic: $13, $51, $71, and $56). VIA was less expensive than HPV unless HPV screening could be reduced to a single visit. Conclusions Preventative cryotherapy was the least expensive strategy and resulted in highest projected life expectancy, while VIA was most cost-effective unless HPV could be reduced to a single visit.http://link.springer.com/article/10.1186/s12962-017-0075-6Cervical cancerCost effectivenessHIVVIACryotherapy |
| spellingShingle | Marita R. Zimmermann Elisabeth Vodicka Joseph B. Babigumira Timothy Okech Nelly Mugo Samah Sakr Louis P. Garrison Michael H. Chung Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya Cost Effectiveness and Resource Allocation Cervical cancer Cost effectiveness HIV VIA Cryotherapy |
| title | Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya |
| title_full | Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya |
| title_fullStr | Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya |
| title_full_unstemmed | Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya |
| title_short | Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya |
| title_sort | cost effectiveness of cervical cancer screening and preventative cryotherapy at an hiv treatment clinic in kenya |
| topic | Cervical cancer Cost effectiveness HIV VIA Cryotherapy |
| url | http://link.springer.com/article/10.1186/s12962-017-0075-6 |
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