Cost-effectiveness of increased hiv testing among MSM in the netherlands.
Reitsema, Maarten Steffers, Linda Visser, Maartje Heijne, Janneke Hoek, Albert Jan Van Loeff, Maarten Schim Van Der van Sighem, Ard van Benthem, Birgit Wallinga, Jacco Xiridou, Maria
Reitsema, Maarten
Steffers, Linda
Visser, Maartje
Heijne, Janneke
Hoek, Albert Jan Van
Loeff, Maarten Schim Van Der
van Sighem, Ard
van Benthem, Birgit
Wallinga, Jacco
Xiridou, Maria
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Series / Report no.
Open Access
Type
Article
Language
en
Date of publication
2019-03-15
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Cost-effectiveness of increased hiv testing among MSM in the netherlands.
Translated Title
Published in
AIDS 2019; 33(12):1807-17
Abstract
To assess the cost-effectiveness of increased consistent HIV testing among men who have sex with men (MSM) in the Netherlands. Among MSM testing at STI clinics in the Netherlands in 2014-2015, approximately 20% tested consistently every six months. We examined four scenarios with increased percentage of MSM testing every six months: a small and a moderate increase among all MSM; a small and a moderate increase only among MSM with ≥10 partners in the preceding six months. We used an agent-based model to calculate numbers of HIV infections and AIDS cases prevented with increased HIV testing. These numbers were used in an economic model to calculate costs, quality-adjusted life-years (QALY), and incremental cost-effectiveness ratios (ICER) due to increased testing, over 2018-2027, taking a healthcare payer perspective. A small increase in the percentage testing every six months among all MSM resulted in 490 averted HIV infections and an average ICER of &OV0556;27,900/QALY gained. A moderate increase among all MSM, resulted in 1380 averted HIV infections and an average ICER of &OV0556;36,700/QALY gained. Both were not cost-effective, with a &OV0556;20,000 willingness-to-pay threshold. Increasing the percentage testing every six months only among MSM with ≥10 partners in the preceding six months resulted in less averted HIV infections than increased testing among all MSM, but was on average cost-saving. Increased HIV testing can prevent considerable numbers of new HIV infections among MSM, but may be cost-effective only if targeted at high-risk individuals, such as those with many partners.