Estimating the Cost-Effectiveness of HIV Prevention Programmes in Vietnam, 2006-2010: A Modelling Study

PLoS One. 2015 Jul 21;10(7):e0133171. doi: 10.1371/journal.pone.0133171. eCollection 2015.

Abstract

Introduction: Vietnam has been largely reliant on international support in its HIV response. Over 2006-2010, a total of US$480 million was invested in its HIV programmes, more than 70% of which came from international sources. This study investigates the potential epidemiological impacts of these programmes and their cost-effectiveness.

Methods: We conducted a data synthesis of HIV programming, spending, epidemiological, and clinical outcomes. Counterfactual scenarios were defined based on assumed programme coverage and behaviours had the programmes not been implemented. An epidemiological model, calibrated to reflect the actual epidemiological trends, was used to estimate plausible ranges of programme impacts. The model was then used to estimate the costs per averted infection, death, and disability adjusted life-year (DALY).

Results: Based on observed prevalence reductions amongst most population groups, and plausible counterfactuals, modelling suggested that antiretroviral therapy (ART) and prevention programmes over 2006-2010 have averted an estimated 50,600 [95% uncertainty bound: 36,300-68,900] new infections and 42,600 [36,100-54,100] deaths, resulting in 401,600 [312,200-496,300] fewer DALYs across all population groups. HIV programmes in Vietnam have cost an estimated US$1,972 [1,447-2,747], US$2,344 [1,843-2,765], and US$248 [201-319] for each averted infection, death, and DALY, respectively.

Conclusions: Our evaluation suggests that HIV programmes in Vietnam have most likely had benefits that are cost-effective. ART and direct HIV prevention were the most cost-effective interventions in reducing HIV disease burden.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis*
  • HIV Infections / economics
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • Humans
  • Models, Statistical
  • National Health Programs / economics
  • Primary Prevention / economics*
  • Primary Prevention / organization & administration
  • Vietnam

Grants and funding

This research was supported by the World Bank under the terms of the contract number: 8004397. QDP is supported by an AusAID PhD scholarship. DPW’s work was funded in part by the Australian National Health and Medical Research Council. The Kirby Institute is funded by the Australian Government, Department of Health and Ageing and is affiliated with the UNSW Australia.