自贡市艾滋病扩大检测工作的卫生经济学分析

Health economics analysis of expanded HIV testing in Zigong

目的分析2018—2020年自贡市艾滋病扩大检测工作的成本效果,为修订艾滋病防控策略提供依据。方法通过WPS建立数据库,获取2018—2020年自贡市艾滋病扩大检测工作的成本投入和检出的HIV/AIDS病例数;TreeAge Pro 2011建立马尔科夫模型,模拟该项目获取的质量调整生命年(QALY),综合评估自贡市艾滋病扩大检测工作的成本效果。结果2018—2020年自贡市艾滋病扩大检测工作累计投入经费3383.10万元,发现HIV/AIDS病例3522例,每发现1例HIV/AIDS病例的成本是0.96万元。Markov模型拟合结果显示,每发现1例HIV/AIDS获得的QALY平均数10.2185个,累计挽回35989.5570个QALY,艾滋病扩大检测工作总体的成本效果为0.0940万元/QALY。项目共挽回GDP损失110.63亿元,挽回个人收入59.54亿元。结论自贡市在2018—2020年期间开展的艾滋病扩大检测工作具有极高的成本效果,应进一步加强检测力度,同时也要注意及时调整筛查方向。

Objective To evaluate the cost effectiveness of extended HIV testing from 2018 to 2020in Zigong.Methods We obtained the data about cost of extended HIV testing and the number of detected HIV/AIDS cases from 2018 to 2020 in Zigong.The Markov model was built via Treeage Pro 2011 to simulate the quality adjusted life year(QALY)obtained by the project,thus providing a comprehensive evaluation of the cost effectiveness of expanded HIV testing in Zigong.Results The cost of extended HIV testing from 2018 to 2020 in Zigong was 33.831 million Yuan.A total of 3522 HIV/AIDS cases were found in the project;the cost per HIV/AIDS case is 9600 Yuan.According to the Markov model,10.2185 QALYs could be gained per HIV/AIDS case on average,and the total QALYs gained from the project was 35989.5570.The overall cost effectiveness ratio of the project was 940 Yuan per QALY.The project would save GDP 11.063 billion yuan and save the personal income 5.954 billion yuan.Conclusions The expanded HIV testing program has a very high cost effectiveness from 2018 to 2020 years in Zigong.We should further strengthen the detection efforts,and pay attention to adjust the screening direction in time.