Incremental cost-effectiveness of two zidovudine regimens to prevent perinatal HIV transmission in the United States.

Recently concluded clinical trials in Thailand have demonstrated that a short course of zidovudine therapy administered to human immunodeficiency virus-infected women during late pregnancy and labor can substantially reduce the likelihood of perinatal transmission of HIV. This regimen is both less expensive and less effective than the full course of therapy recommended for use in the United States by the U.S. Public Health Service (PHS). The objective of the current study is to estimate the incremental cost-effectiveness of the full-course zidovudine regimen in comparison to the short-course regimen that was tested in Thailand and to determine conditions under which the PHS-recommended regimen produces a net savings in societal resource utilization, relative to the shorter regimen. We used standard methods of incremental cost-effectiveness analysis and derived cost and effectiveness estimates from published studies. The main outcome measure is the incremental cost-effectiveness ratio, which is the additional cost per additional case of perinatal HIV infection averted by the full course of therapy. Full-course zidovudine therapy costs an additional $21,337 per additional case of HIV infection averted, relative to the shorter regimen; this is much less than the cost of treating a case of pediatric HIV infection. Economic and clinical findings both favor full-course zidovudine therapy over short-course therapy to prevent perinatal transmission of HIV in the United States.

Pinkerton SD ，Holtgrave DR ，Layde PM 《PREVENTIVE MEDICINE》

Cost-effectiveness of interventions to reduce vertical HIV transmission from pregnant women who have not received prenatal care.

Mrus JM ，Tsevat J 《MEDICAL DECISION MAKING》

Administration of zidovudine during late pregnancy and delivery to prevent perinatal HIV transmission--Thailand, 1996-1998.

Centers for Disease Control and Prevention (CDC) 《MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT》

From research to practice: use of short course zidovudine to prevent mother-to-child HIV transmission in the context of routine health care in Northern Thailand.

Thaineua V ，Sirinirund P ，Tanbanjong A ，Lallemant M ，Soucat A ，Lamboray JL ... -  《SOUTHEAST ASIAN JOURNAL OF TROPICAL MEDICINE AND PUBLIC HEALTH》

Cost-effectiveness of chemoprophylaxis after occupational exposure to HIV.

Pinkerton SD ，Holtgrave DR ，Pinkerton HJ 《ARCHIVES OF INTERNAL MEDICINE》