Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya

This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryotherapy without screening, visu...

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Bibliographic Details
Published in:Cost effectiveness and resource allocation 2017-07, Vol.15 (1), p.13-13, Article 13
Main Authors: Zimmermann, Marita R, Vodicka, Elisabeth, Babigumira, Joseph B, Okech, Timothy, Mugo, Nelly, Sakr, Samah, Garrison, Louis P, Chung, Michael H
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Age
AIDS
Biopsy
Cancer
Cervical cancer
Cervix
Clinics
Cold
Cost analysis
Cost control
Cost effectiveness
Cross-sectional studies
Cryotherapy
Diagnosis
Economic aspects
Genetic testing
Health aspects
HIV
Human immunodeficiency virus
Human papillomavirus
Medical care, Cost of
Medical screening
Mortality
Pap smear
Papillomavirus infections
Prevention
Probability
Sensitivity analysis
Studies
VIA
Womens health
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Summary:This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryotherapy without screening, visual inspection with acetic acid (VIA), Papanicolaou smear (Pap), and testing for human papillomavirus (HPV). Direct and indirect medical and non-medical costs were examined from societal and clinic perspectives. Costs of cryotherapy, VIA, Pap, and HPV for women with CD4 200-500 cells/mL were $99, $196, $219, and $223 from a societal perspective and $19, $94, $124, and $113 from a clinic perspective, with 17.3, 17.1, 17.1, and 17.1 years of life expectancy, respectively. Women at higher CD4 counts (>500 cells/mL) given cryotherapy VIA, Pap, and HPV resulted in better life expectancies (19.9+ years) and lower cost (societal: $49, $99, $115, and $102; clinic: $13, $51, $71, and $56). VIA was less expensive than HPV unless HPV screening could be reduced to a single visit. Preventative cryotherapy was the least expensive strategy and resulted in highest projected life expectancy, while VIA was most cost-effective unless HPV could be reduced to a single visit.
ISSN:1478-7547
1478-7547
DOI:10.1186/s12962-017-0075-6