International Journal of STD & AIDS > Volume 19, Number 10 > Pp. 668-675

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Original research articles

Cost-effectiveness estimates for antenatal HIV testing in the Netherlands

M H Rozenbaum BSc MSc ^*, G Verweel MSc MD , D K F Folkerts RN , F Dronkers BSc MSc ^*, J A R van den Hoek MD PhD  , N G Hartwig MSc PhD , R de Groot PhD  and M J Postma PhD  ^** 

^* Department of Pharmacy, University of Groningen, Groningen; Department of Immunology, Erasmus Medical Centre, Rotterdam; Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam; Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Centre, Amsterdam; ^** Department of Epidemiology, University Medical Centre Groningen, Groningen; Department of Pediatrics, University Medical Centre Nijmegen, Nijmegen, The Netherlands

Correspondence to: Maarten J Postma, Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, Groningen Research Institute of Pharmacy (GRIP), Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands Email: m.j.postma{at}rug.nl

This paper provides an estimation of the lifetime health-care cost of HIV-infected children and an update of the cost-effectiveness of universal HIV-screening of pregnant women in Amsterdam (The Netherlands). During 2003–2005, we collected data concerning the prevalence of newly diagnosed HIV-infected pregnant women in Amsterdam. Also, data on resource utilization and HAART regimen for HIV-infected children was gathered from a national registry. Using Kaplan-Meier survival analysis, we estimated the life-expectancy of a vertically HIV-infected child at 19 years, with the corresponding lifetime health-care costs of 179,974. HIV-screening of pregnant women could prevent 2.4 HIV transmissions annually in Amsterdam, based on an estimated prevalence of nine yet undiagnosed HIV-positive pregnant women per 10,000 pregnancies. We show that universal HIV screening during pregnancy generates significant net cost savings and health benefits in most situations. Universal antenatal HIV screening is justified in Amsterdam from a health-economic point of view.

Key Words: AIDS • cost-effectiveness analyses • mother-to-child transmission • antenatal HIV-screening • health economics

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