2010～2013年钦州市扩大HIV筛查工作的成本效益分析

Analysis on cost-effectiveness of HIV screening in Qinzhou,2010- 2013

目的分析2010~2013年广西钦州市开展HIV筛查检测工作的成本效益。方法计算2010~2013年钦州市用于HIV筛查检测的经费,统计工作检出的HIV/AIDS和抗病毒治疗数据,建立马尔科夫（Markov）5树模型,评估HIV筛查检测工作获得的质量调整生命年（QALY）,分析该项工作的成本效益。结果 2010~2013年钦州市共投入经费3 971.96万元用于HIV筛查检测工作,检出HIV/AIDS阳性病例5 040例;钦州市辖区、灵山县和浦北县HIV检测平均成本23.655元/例、21.413元/例和20.374元/例,HIV/AIDS阳性检出的平均成本为1.260万元/例、0.448万元/例和1.007万元/例,通过检出HIV/AIDS获得的QALY平均数分别为8.198、8.448和9.575个,挽回的QALY总数为12 444.564、22 463.232和8 263.225个;整体成本效果为0.092万元/QALY;3地成本效益分别为0.154万元/QALY、0.053万元/QALY和0.105万元/QALY,灵山县成本效益优于市辖区、浦北县。结论钦州市2010~2013年开展的HIV筛查检测成本效益较好,加强HIV/AIDS的抗病毒治疗工作有利于提高筛查检测工作的成本效益。

Objective To analyze the cost-effectiveness of HIV Screening in Qinzhou City from 2010 to 2013. Methods The funds of HIV screening in Qinzhou City from 2010 to 2013 were calculated, and the data of HIV/AIDS cases and antiviral treatment cases were counted. The tree model of Markov 5 was established to evaluate the quality adjusted life year（QALY） obtained from the HIV screening, and the cost-effectiveness of the screening was analyzed. Results The cost of HIV screening in Qinzhou City from 2010 to 2013 amounted to 3 971.96 million yuan,with 5 040 HIV/AIDS-postive cases confirmed. The average costs of HIV screening in urban axea,Lingshan County and Pubei County in Qinzhou City were 23.655,21. 413 and 20. 374 yuan per case ,respectively ,and the average costs of HIV/AIDS-positive detection in the three areas were 12.60,4.48 and 10.07 thousand yuan per case ,respectively. The QALYs gained from the HIV/AIDS screening were 8. 198,8.448 and 9. 575 on average,respectively,and the total QALYs gained from the HIV screening were 12 444. 564,22 463. 232 and 8 263. 225. The cost-effectiveness ratio of the HIV screening was 0. 920 thousand yuan per QALY in overall, and 1.54,0.53 and 1.05 thousand yuan per QALY individually in the three areas mentioned above. The Lingshan County had better cost-effectiveness compared with the others. Conclusion The HIV screening conducted in Qinzhou City from 2010 to 2013 achieved better cost-effectiveness. Intensifying the antiviral treatment for HIV/AIDS is conducive to improving the cost-effective of the screening.