Health Economics and Epidemiology Research Office (HE2RO), Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Center for Global Health and Development, Boston University, Boston, Massachusetts, United States of America.
PLoS One. 2019 Feb 26;14(2):e0210497. doi: 10.1371/journal.pone.0210497. eCollection 2019.
In economic analyses of HIV interventions, South Africa is often used as a case in point, due to the availability of good epidemiological and programme data and the global relevance of its epidemic. Few analyses however use locally relevant cost data. We reviewed available cost data as part of the South African HIV Investment Case, a modelling exercise to inform the optimal use of financial resources for the country's HIV programme.
We systematically reviewed publication databases for published cost data covering a large range of HIV interventions and summarised relevant unit costs (cost per person receiving a service) for each. Where no data was found in the literature, we constructed unit costs either based on available information regarding ingredients and relevant public-sector prices, or based on expenditure records.
Only 42 (5%) of 1,047 records included in our full-text review reported primary cost data on HIV interventions in South Africa, with 71% of included papers covering ART. Other papers detailed the costs of HCT, MMC, palliative and inpatient care; no papers were found on the costs of PrEP, social and behaviour change communication, and PMTCT. The results informed unit costs for 5 of 11 intervention categories included in the Investment Case, with the remainder costed based on ingredients (35%) and expenditure data (10%).
A large number of modelled economic analyses of HIV interventions in South Africa use as inputs the same, often outdated, cost analyses, without reference to additional literature review. More primary cost analyses of non-ART interventions are needed.
在 HIV 干预措施的经济分析中，南非经常被作为一个典型案例，因为其具有良好的流行病学和项目数据，并且其艾滋病流行情况在全球范围内具有相关性。然而，很少有分析使用当地相关的成本数据。我们审查了现有的成本数据，这些数据是作为南非 HIV 投资案例的一部分，该案例是一项建模工作，旨在为该国的 HIV 规划提供最佳利用财政资源的信息。
我们系统地审查了出版物数据库，以查找涵盖广泛 HIV 干预措施的已发表成本数据，并对每一项干预措施的相关单位成本（接受服务的人均成本）进行了总结。在文献中未找到数据的情况下，我们根据有关成分和相关公共部门价格的可用信息，或者根据支出记录来构建单位成本。
在我们的全文审查中，只有 42 篇（5%）记录报告了南非 HIV 干预措施的原始成本数据，其中 71%的论文涵盖了抗逆转录病毒治疗。其他论文详细介绍了 HIV 检测、母婴阻断、姑息治疗和住院治疗的成本；没有找到关于预防用药、社会和行为改变沟通以及母婴传播预防的成本的论文。审查结果为投资案例中包含的 11 个干预类别中的 5 个提供了单位成本，其余类别则基于成分（35%）和支出数据（10%）进行了成本估算。
在南非，大量对 HIV 干预措施的建模经济分析使用相同的、往往是过时的成本分析作为投入，而没有参考额外的文献综述。需要进行更多非抗逆转录病毒治疗干预措施的原始成本分析。
