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Table 5 CEA with a health outcome: cost per HIV infection averted

From: Cost-effectiveness analyses of training: a manager’s guide

  Pre-training Post-training
Program cost   
Remuneration   
Clinical staff, including counselors $65,000 $72,000
Supervisory staff $15,000 $12,000
Total remuneration $80,000 $84,000
Supplies, including HIV test kits and ARV drugs $15,000 $18,000
Capital (annuitized)   
Vehicle $3,000 $3,000
Equipment $500 $500
Building $1,500 $1,500
Training $0 $5,000
Total Capital $5,000 $10,000
Total program cost $100,000 $112,000
Estimate of effectiveness   
Number of mother infant pairs that PMTCT 1000 1200
Estimated vertical HIV transmission before and at birth*   
Base case  25% 25%
Lower bound  19% 19%
Upper bound  30% 30%
Effectiveness of regimen for mothers and infant 63% 63%
Estimated HIV infections averted   
 Base case (1000*.25*.63) =158 (1000*.25*.63) =189
 Lower bound 120 144
 Upper bound 189 227
Cost-effectiveness analysis   
Incremental cost ($112,000-$100,000) = $12,000
Incremental HIV infection averted   
 Base case   (189–158) = 31
 Lower bound   (144–120) = 24
 Upper bound   (227–189) = 38
Incremental cost-effectiveness ratio (ICER)   
 Base case   ($12,000/31)=$283
 Lower bound   $215
 Upper bound   $340
  1. *The effect of the training on MTCT is uncertain because there is a range of estimates for vertical HIV transmission before and during birth. The midpoint of the range is used to estimate effectiveness for the base case, and a sensitivity analysis is conducted with the lower and upper bounds. The base case and range are also reported for the number of HIV infections averted and ICER.