Research Article

Universal Rapid Human Immunodeficiency Virus Screening at Delivery: A Cost-Effectiveness Analysis

Table 3

Sensitivity analysis values and ranges.

VariableRangeReference

QALY saved per prevention of 1 case of MTCT5–[20, 2530]
Estimated lifetime medical cost of PAH250k–$550[20, 2528, 31, 32]
HIV prevalence0.5%–10%
HIV annual cumulative incidence0.01%–0.15%
Cost of rapid test$11.90–$16.32
Neonatal prophylaxis$185–$210

was set to cover the cost value obtained from the references (after it was updated to 2015 dollars). A 3% discount rate was applied to indicate a present value. range was set to examine the impact of extreme value on the estimated outcomes, not necessarily indicating a highest or lowest rate in District of Columbia. was set based on the minimum and maximum of Medicare Clinical Diagnostic Laboratory Fee Schedule among different locations for the same service. also considered three-drug prophylaxis, with Lamivudine in addition to AZT and Nevirapine. 240 ml of the 10 mg/ml oral solution costs $76.52, per the Neonatal Pharmacy Department of MedStar Washington Hospital Center. By the US AIDS info guidelines, a 3500 g neonate requires 784 mg total of Lamivudine ($25), in addition to AZT and Nevirapine ($185).