Optimal investment in HIV prevention programs: more is not always better.

Health Care Management Science
M L Brandeau, Gregory S Zaric

Abstract

This paper develops a mathematical/economic framework to address the following question: Given a particular population, a specific HIV prevention program, and a fixed amount of funds that could be invested in the program, how much money should be invested? We consider the impact of investment in a prevention program on the HIV sufficient contact rate (defined via production functions that describe the change in the sufficient contact rate as a function of expenditure on a prevention program), and the impact of changes in the sufficient contact rate on the spread of HIV (via an epidemic model). In general, the cost per HIV infection averted is not constant as the level of investment changes, so the fact that some investment in a program is cost effective does not mean that more investment in the program is cost effective. Our framework provides a formal means for determining how the cost per infection averted changes with the level of expenditure. We can use this information as follows: When the program has decreasing marginal cost per infection averted (which occurs, for example, with a growing epidemic and a prevention program with increasing returns to scale), it is optimal either to spend nothing on the program or to spend t...Continue Reading

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Citations

Dec 31, 2010·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Sabina S Alistar, Margaret L Brandeau
Jun 25, 2013·Health Care Management Science·Sabina S AlistarEduard J Beck
Jul 16, 2010·Health Care Management Science·Shengfan ZhangKathleen M Diehl
Mar 30, 2012·Health Care Management Science·Monali S Malvankar-Mehta, Bin Xie
Jun 15, 2012·Health Care Management Science·Geoff Royston
Nov 26, 2015·BMC Health Services Research·Jinwoo J ImJodie A Trafton
Sep 10, 2015·Journal of Public Health Management and Practice : JPHMP·Emine YaylaliStephanie L Sansom
Sep 16, 2015·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Jessie L Juusola, Margaret L Brandeau
Nov 13, 2009·Applied Health Economics and Health Policy·Steffen Flessa
Nov 1, 2020·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Anton L V Avanceña, David W Hutton
Nov 25, 2021·Mathematical Biosciences and Engineering : MBE·Seyedeh N Khatami, Chaitra Gopalappa

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