Cost-Effectiveness of Voluntary HIV Testing Strategies in a Very Low-Prevalence Country, the Republic of Korea.
10.3346/jkms.2018.33.e304
- Author:
Young Hwa LEE
1
;
Ji Hwan BANG
;
Sang Min PARK
;
Cho Ryok KANG
;
Sung Il CHO
;
Myoung don OH
;
Jong Koo LEE
Author Information
1. Department of Epidemiology, Seoul National University Graduate School of Public Health, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
HIV Screening Test;
Cost-effectiveness Analysis;
Korea
- MeSH:
Cost-Benefit Analysis;
Diagnosis;
Enzyme-Linked Immunosorbent Assay;
HIV Infections;
HIV*;
Humans;
Korea;
Mass Screening;
Prevalence;
Public Health;
Republic of Korea*
- From:Journal of Korean Medical Science
2018;33(46):e304-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The Republic of Korea has a very low prevalence of human immunodeficiency virus (HIV) infection, but the number of new HIV diagnoses has steadily risen, strongly indicating a large number of undetected HIV infections. Thus, it is important for Korean public health authorities to adopt and encourage cost-effective HIV detection tools, such as rapid HIV screening tests. In this study, we aimed to evaluate the cost-effectiveness of enzyme-linked immunosorbent assays (ELISA) and rapid tests in a public health center (PHC) setting. METHODS: We developed a decision analytic model to assess the per-examinee cost and the cost-effectiveness of identifying HIV patients in a PHC setting using two HIV testing strategies: conventional HIV screening by ELISA versus rapid HIV testing. Analysis was performed in two scenarios: HIV testing in an average-risk population and in a high-risk population. RESULTS: Compared to the ELISA, the rapid test was cost-saving and cost-effective. The per-examinee cost was USD 1.61 with rapid testing versus USD 3.38 with ELISA in an average-risk population, and USD 4.77 with rapid testing versus USD 7.62 with ELISA in a high-risk population. The cost of identifying a previously undiagnosed HIV case was USD 26,974 with rapid testing versus USD 42,237 with ELISA in an average-risk population, and USD 153 with rapid testing versus USD 183 with ELISA in a high-risk population. CONCLUSION: Rapid testing would be more cost-effective than using conventional ELISA testing for identifying previously undiagnosed HIV-infected cases in Korea, a country with extremely low HIV prevalence.
