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@article{Thomas:2021:10.1016/S2214-109X(21)00034-6,
author = {Thomas, R and Probert, W and Sauter, R and Mwenge, L and Singh, S and Kanema, S and Vanqa, N and Harper, A and Burger, R and Cori, A and Pickles, M and Bell-Mandla, N and Yang, B and Bwalya, J and Phiri, M and Shanaube, K and Floyd, S and Donnell, D and Bock, P and Ayles, H and Fidler, S and Hayes, R and Fraser, C and Hauck, K},
doi = {10.1016/S2214-109X(21)00034-6},
journal = {The Lancet Global Health},
pages = {e668--e680},
title = {Cost and cost-effectiveness of a universal HIV testing and treatment intervention in Zambia and South Africa: evidence and projections from the HPTN 071 (PopART) trial},
url = {http://dx.doi.org/10.1016/S2214-109X(21)00034-6},
volume = {9},
year = {2021}
}

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TY  - JOUR
AB  - BackgroundThe HPTN 071 (PopART) trial showed that a combination HIV prevention package including universal HIV testing and treatment (UTT) reduced population-level incidence of HIV compared with standard care. However, evidence is scarce on the costs and cost-effectiveness of such an intervention.MethodsUsing an individual-based model, we simulated the PopART intervention and standard care with antiretroviral therapy (ART) provided according to national guidelines for the 21 trial communities in Zambia and South Africa (for all individuals aged >14 years), with model parameters and primary cost data collected during the PopART trial and from published sources. Two intervention scenarios were modelled: annual rounds of PopART from 2014 to 2030 (PopART 2014–30; as the UNAIDS Fast-Track target year) and three rounds of PopART throughout the trial intervention period (PopART 2014–17). For each country, we calculated incremental cost-effectiveness ratios (ICERs) as the cost per disability-adjusted life-year (DALY) and cost per HIV infection averted. Cost-effectiveness acceptability curves were used to indicate the probability of PopART being cost-effective compared with standard care at different thresholds of cost per DALY averted. We also assessed budget impact by projecting undiscounted costs of the intervention compared with standard care up to 2030.FindingsDuring 2014–17, the mean cost per person per year of delivering home-based HIV counselling and testing, linkage to care, promotion of ART adherence, and voluntary medical male circumcision via community HIV care providers for the simulated population was US$6·53 (SD 0·29) in Zambia and US$7·93 (0·16) in South Africa. In the PopART 2014–30 scenario, median ICERs for PopART delivered annually until 2030 were $2111 (95% credible interval [CrI] 1827–2462) per HIV infection averted in Zambia and $3248 (2472–3963) per HIV infection averted in South Afric
AU  - Thomas,R
AU  - Probert,W
AU  - Sauter,R
AU  - Mwenge,L
AU  - Singh,S
AU  - Kanema,S
AU  - Vanqa,N
AU  - Harper,A
AU  - Burger,R
AU  - Cori,A
AU  - Pickles,M
AU  - Bell-Mandla,N
AU  - Yang,B
AU  - Bwalya,J
AU  - Phiri,M
AU  - Shanaube,K
AU  - Floyd,S
AU  - Donnell,D
AU  - Bock,P
AU  - Ayles,H
AU  - Fidler,S
AU  - Hayes,R
AU  - Fraser,C
AU  - Hauck,K
DO  - 10.1016/S2214-109X(21)00034-6
EP  - 680
PY  - 2021///
SN  - 2214-109X
SP  - 668
TI  - Cost and cost-effectiveness of a universal HIV testing and treatment intervention in Zambia and South Africa: evidence and projections from the HPTN 071 (PopART) trial
T2  - The Lancet Global Health
UR  - http://dx.doi.org/10.1016/S2214-109X(21)00034-6
UR  - http://hdl.handle.net/10044/1/87080
VL  - 9
ER  -

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