Cost, Effectiveness, and Incremental Cost-Effectiveness of Expanded Testing for Primary HIV Infection of 3,030,303 Hypothetical Patients at a Prevalence of 0.66% With Third-Generation HIV-1 EIA, p24 Antigen EIA, and HIV-1 RNA Assay
| Variable | No Testing | Third-Generation HIV-1 EIA | p24 Antigen EIA | HIV-1 RNA Assay |
|---|---|---|---|---|
| Note: each column is compared with the one to the left. | ||||
| HIV = human immunodeficiency virus; EIA = enzyme immunosorbent assay; QALYs = quality-adjusted life-years. | ||||
| * Dominated means this option cost more and was less effective than other options. | ||||
| Cost (millions), $ | 1,762.1 | 2,233.6 | 2,258.2 | 2,561.8 |
| Incremental cost (millions), $ | — | 471.5 | 24.6 | 303.6 |
| Effectiveness (thousands) QALYs | 69,710.0 | 69,720.8 | 69,726.1 | 69,725.8 |
| Incremental effectiveness, QALYs | — | 10,800 | 5,300 | (300) |
| Effectiveness, No. | ||||
| Primary HIV infection cases diagnosed | — | 15,803 | 17,054 | 20,000 |
| Primary HIV infection cases lost to care (31% of those diagnosed) | 20,000 | 4,899 | 5,287 | 6,200 |
| False-positive diagnoses | — | 90,257 | 1,127 | 59,169 |
| False-negative diagnoses | — | 2,924 | 3,012 | 0 |
| Cases avoided per behavior change | 403 | 435 | 501 | |
| Cost-effectiveness, $ | ||||
| Testing cost per case identified | — | 29,836 | 29,090 | 39.985 |
| Incremental cost per quality-adjusted year of life gained | — | Dominated* | 30,800 | Dominated* |