预防艾滋病母婴传播综合措施的费用效果分析

Cost-effectiveness analysis for integrated prevention of mother-to-child transmission of HIV

目的对艾滋病高发地区4个预防艾滋病母婴传播项目县的预防艾滋病母婴传播综合措施进行经济学评价，探讨其费用效果及经济学效率。方法运用项目全成本核算的方法，通过现场调查收集2003--2006年实施预防艾滋病母婴传播各项措施的费用和干预效果，计算每发现1例HIV感染孕产妇、避免1例儿童新发感染HIV和挽救1个残疾调整寿命年（DALY）的费用。结果孕产期每发现1例HIV感染孕产妇的费用平均为5512元（人民币），综合措施避免1例儿童HIV感染的费用为46747元（人民币），挽回1个DALY的费用为1870元（人民币），折合231美元。结论项目地区预防艾滋病母婴传播干预措施费用低，经济学效率较高。

Objective To evaluate the cost-effectiveness and economic efficiency of integrated prevention of mother-to-child transmission （ PMTCT ） of HIV in four high-incidence counties. Methods Data of local resource investment and total cost for PMTCT in 4 counties in China from 2003 to 2006 were collected. Cost analysis and cost-effectiveness analysis were conducted. Average costs of a confirmed HIV case, a prevented case and a disability-adjusted life-year （DALY） saving were calculated. Results Average cost of identifying one HIV-infected mother was ￥5512. Costs of a pediatric HIV case prevention and per DALY saving were ￥46 747 and ￥1870 （ $231 ）, respectively, based on the total cost perspective. Conclusion The cost of integrated prevention of mother-to-child transmission of HIV was low. The PMTCT program was economical efficiency.