Abstract
With efficacious behavioral, biomedical, and structural interventions available, combination implementation strategies are being implemented to combat HIV/AIDS across settings internationally. However, priority statements from national and international bodies make it unclear whether the objective should be the reduction in HIV incidence or the maximization of health, most commonly measured with quality-adjusted life years (QALYs). Building off a model-based evaluation of HIV care interventions in British Columbia, Canada, we compare the optimal sets of interventions that would be identified using HIV infections averted, and QALYs as the primary outcome in a cost-effectiveness analysis. We found an explicit focus on averting new infections undervalues the health benefits derived from antiretroviral therapy, resulting in suboptimal and potentially harmful funding recommendations.
| Original language | English (US) |
|---|---|
| Journal | Journal of the International Association of Providers of AIDS Care |
| Volume | 18 |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- economic evaluation
- economic model
- HIV
- quality-adjusted life years
ASJC Scopus subject areas
- Immunology
- Dermatology
- Infectious Diseases
Cite this
Why Maximizing Quality-Adjusted Life Years, rather than Reducing HIV Incidence, Must Remain Our Objective in Addressing the HIV/AIDS Epidemic. / Nosyk, Bohdan; Min, Jeong Eun; Zang, Xiao; Feaster, Daniel J; Metsch, Lisa; Marshall, Brandon D.L.; Rio, Carlos Del; Granich, Reuben; Schackman, Bruce R.; Montaner, Julio S.G.
In: Journal of the International Association of Providers of AIDS Care, Vol. 18, 01.01.2019.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Why Maximizing Quality-Adjusted Life Years, rather than Reducing HIV Incidence, Must Remain Our Objective in Addressing the HIV/AIDS Epidemic
AU - Nosyk, Bohdan
AU - Min, Jeong Eun
AU - Zang, Xiao
AU - Feaster, Daniel J
AU - Metsch, Lisa
AU - Marshall, Brandon D.L.
AU - Rio, Carlos Del
AU - Granich, Reuben
AU - Schackman, Bruce R.
AU - Montaner, Julio S.G.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - With efficacious behavioral, biomedical, and structural interventions available, combination implementation strategies are being implemented to combat HIV/AIDS across settings internationally. However, priority statements from national and international bodies make it unclear whether the objective should be the reduction in HIV incidence or the maximization of health, most commonly measured with quality-adjusted life years (QALYs). Building off a model-based evaluation of HIV care interventions in British Columbia, Canada, we compare the optimal sets of interventions that would be identified using HIV infections averted, and QALYs as the primary outcome in a cost-effectiveness analysis. We found an explicit focus on averting new infections undervalues the health benefits derived from antiretroviral therapy, resulting in suboptimal and potentially harmful funding recommendations.
AB - With efficacious behavioral, biomedical, and structural interventions available, combination implementation strategies are being implemented to combat HIV/AIDS across settings internationally. However, priority statements from national and international bodies make it unclear whether the objective should be the reduction in HIV incidence or the maximization of health, most commonly measured with quality-adjusted life years (QALYs). Building off a model-based evaluation of HIV care interventions in British Columbia, Canada, we compare the optimal sets of interventions that would be identified using HIV infections averted, and QALYs as the primary outcome in a cost-effectiveness analysis. We found an explicit focus on averting new infections undervalues the health benefits derived from antiretroviral therapy, resulting in suboptimal and potentially harmful funding recommendations.
KW - economic evaluation
KW - economic model
KW - HIV
KW - quality-adjusted life years
UR - http://www.scopus.com/inward/record.url?scp=85062057163&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062057163&partnerID=8YFLogxK
U2 - 10.1177/2325958218821962
DO - 10.1177/2325958218821962
M3 - Article
C2 - 30798657
AN - SCOPUS:85062057163
VL - 18
JO - Journal of the International Association of Providers of AIDS Care
JF - Journal of the International Association of Providers of AIDS Care
SN - 2325-9574
ER -