Table 2.

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

VariableNo TestingThird-Generation HIV-1 EIAp24 Antigen EIAHIV-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), $1,762.12,233.62,258.22,561.8
Incremental cost (millions), $471.524.6303.6
Effectiveness (thousands) QALYs69,710.069,720.869,726.169,725.8
Incremental effectiveness, QALYs10,8005,300(300)
Effectiveness, No.
    Primary HIV infection cases diagnosed15,80317,05420,000
    Primary HIV infection cases lost to care (31% of those diagnosed)20,0004,8995,2876,200
    False-positive diagnoses90,2571,12759,169
    False-negative diagnoses2,9243,0120
    Cases avoided per behavior change403435501
Cost-effectiveness, $
    Testing cost per case identified29,83629,09039.985
    Incremental cost per quality-adjusted year of life gainedDominated*30,800Dominated*