To determine if adding HIV screening at the GP level would increase costs, the researchers utilized a mathematical model that, according to the press release, “include[ed] all the costs associated with HIV testing and treatment,” and showed that, “primary care HIV screening in high prevalence settings becomes cost-effective in 33 years (according to National Institute for Health and Care Excellence [NICE] criteria.”
"Currently NICE uses a threshold of £20,000 to £30,000 per Quality Adjusted Life Year (QALY) gained to gauge whether the health benefits of an intervention offer value for money to the National Health Service (NHS) and its patients. 'QALY' is a widely-used measure of health that combines length and quality of life. We found that over 40 years, primary care-based HIV screening in high prevalence areas would cost an estimated £26,626 per QALY gained and therefore warrants funding in the UK," stated Rebecca Baggaley, PhD, lead author of the study and Honorary Lecturer at the London School of Hygiene & Tropical Medicine in the press release.
In addition, according to the press release, GP-screening for HIV, “may even become cost-saving if the long-term healthcare costs of late-diagnosed patients are much higher than those of patients diagnosed earlier, as has been observed in Canada.”
The 74 authorities that were identified as ones that would benefit from GP-screening for HIV are those with the highest HIV prevalence out of the total 325 authorities in England. A total of 11 authorities were identified as having an HIV prevalence similar to Hackney.
According to the press release, “The estimated annual cost of rolling out the screening program to all 11 Hackney-level HIV prevalence authorities would be approximately £600,000 (£4 million for roll-out to all 74 high prevalence authorities). This does not include increased healthcare costs resulting from earlier HIV diagnosis and treatment which would fall under other National Health Service budgets.”
The authors note that limitations of the study included the fact that, “some data, including probability of viral transmission to partners and quality of life, have been estimated based on international literature and may therefore not accurately reflect the Hackney situation.”
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