Amsterdam 2015
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| Abstract #2370 - Costing the epidemic | ||||
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Session: 9.1: Costing the epidemic (Symposium) on Wednesday @ 11.30-13.00 in 202 Chaired by Anne Cockroft, Alexander Pastoors Authors: Presenting Author: Mr Erik Lamontagne - UNAIDS, Switzerland |
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| Additional Authors: | ||||
| Aim: The AIDS epidemic is declining in most parts of the world. There is a growing consensus that Ending AIDS 2030 is a feasible program to largely eliminate the disease. UNAIDS launched the Fast-Track strategy in 2014 which requires annual investments that reach a high of US$ 35.6 billion in 2020 then decline. Investing in Ending AIDS 2030 can yield benefits substantially in excess of costs when compared to a program of simply continuing with current coverage constant. | ||||
| Method / Issue: We used the epidemiological projections and detailed costs prepared by Avenir Health and UNAIDS for both scenarios, and estimated the incremental benefits and economic returns of ending AIDS 2030. We considered three approaches to estimating benefits then comparing them to incremental costs of the fast-track. We first calculated incremental cost-effectiveness analysis of the Fast Track. We then employed the traditional cost-of-illness approach which focuses on the productivity of different agents. Finally, we adopted the full income approach that inspired the Lancet Commission on Global Health 2035 to estimates the economic benefits of ending AIDS. Benefits and enlarged treatment costs beyond 2030 and up to 2050 yield a far more complete estimate of the ratio of benefits to costs than do any other methods reviewed. | ||||
| Results / Comments: Ending AIDS 2030 would require an incremental investment of US$193 billion compared to the constant scenario. Such investment would gain 3.5 billion quality-adjusted life-years (QALY) in low- and middle-income countries, representing an incremental cost-effectiveness ratio (ICER) of US$ 49 per QALY-gained. More modest estimates on regional levels using the cost-of-illness and the full income approaches, still point to net economic returns of 13.8 to 20.9 times the investment it required. | ||||
| Discussion: For all regions, fast-tracking to end the AIDS epidemic by 2030 appears to be a highly effective investment. Regional b/c ratios differ. In Eastern and Southern Africa, economic returns exceed costs by a factor of 57 to 1. In this most-affected region, ending AIDS by 2030 can yield savings of treatment costs that exceed scale-up costs. Economic returns are positive for all other regions, ranging from 24.3-fold in Asia-Pacific to 2.4 in Eastern Europe and Central Asia. These positive returns underline the scope of additional gains that could be generated should countries review, and seek to reduce, their treatment costs. | ||||
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