Why Maximizing Quality-Adjusted Life Years, rather than Reducing HIV Incidence, Must Remain Our Objective in Addressing the HIV/AIDS Epidemic

Journal of the International Association of Providers of AIDS Care
Bohdan NosykJ S G Montaner

Abstract

With efficacious behavioral, biomedical, and structural interventions available, combination implementation strategies are being implemented to combat HIV/AIDS across settings internationally. However, priority statements from national and international bodies make it unclear whether the objective should be the reduction in HIV incidence or the maximization of health, most commonly measured with quality-adjusted life years (QALYs). Building off a model-based evaluation of HIV care interventions in British Columbia, Canada, we compare the optimal sets of interventions that would be identified using HIV infections averted, and QALYs as the primary outcome in a cost-effectiveness analysis. We found an explicit focus on averting new infections undervalues the health benefits derived from antiretroviral therapy, resulting in suboptimal and potentially harmful funding recommendations.

References

Jan 22, 2003·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Milton C WeinsteinUNKNOWN ISPOR Task Force on Good Research Practices--Modeling Studies
Mar 11, 2009·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Milton C WeinsteinAlistair McGuire
Sep 10, 2010·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Ana BobinacWerner B F Brouwer
Oct 15, 2010·The New England Journal of Medicine·Peter J Neumann, Milton C Weinstein
Nov 3, 2010·British Medical Bulletin·Sarah J Whitehead, Shehzad Ali
Apr 13, 2011·Lancet·Geoffrey P GarnettNeff Walker
Jul 20, 2011·The New England Journal of Medicine·Myron S CohenUNKNOWN HPTN 052 Study Team
Apr 4, 2014·International Journal of Epidemiology·Kate HeathUNKNOWN STOP HIV/AIDS Study Group
Dec 10, 2014·Health Economics·Karl ClaxtonAnthony J Culyer
Feb 25, 2015·Medical Care·Bruce R SchackmanElena Losina
Mar 8, 2016·American Journal of Preventive Medicine·Feng LinStephanie L Sansom
Jun 11, 2016·Global Health Action·Leigh F JohnsonGesine Meyer-Rath
Oct 14, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Bohdan NosykUNKNOWN STOP HIV/AIDS Study Group

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