Cost-effectiveness of methadone maintenance therapy as HIV prevention in an Indonesian high-prevalence setting: a mathematical modeling study
Publication year
2012Source
International Journal of Drug Policy, 23, 5, (2012), pp. 358-64ISSN
Publication type
Article / Letter to editor
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Organization
IQ Healthcare
Primary and Community Care
Internal Medicine
Journal title
International Journal of Drug Policy
Volume
vol. 23
Issue
iss. 5
Page start
p. 358
Page end
p. 64
Subject
N4i 3: Poverty-related infectious diseases NCEBP 13: Infectious diseases and international health; NCEBP 4: Quality of hospital and integrated care; NCEBP 7: Effective primary care and public health N4i 3: Poverty-related infectious diseasesAbstract
BACKGROUND: Indonesia faces an HIV epidemic that is in rapid transition. Injecting drug users (IDUs) are among the most heavily affected risk populations, with estimated prevalence of HIV reaching 50% or more in most parts of the country. Although Indonesia started opening methadone clinics in 2003, coverage remains low. METHODS: We used the Asian Epidemic Model and Resource Needs Model to evaluate the long-term population-level preventive impact of expanding Methadone Maintenance Therapy (MMT) in West Java (43 million people). We compared intervention costs and the number of incident HIV cases in the intervention scenario with current practice to establish the cost per infection averted by expanding MMT. An extensive sensitivity analysis was performed on costs and epidemiological input, as well as on the cost-effectiveness calculation itself. RESULTS: Our analysis shows that expanding MMT from 5% coverage now to 40% coverage in 2019 would avert approximately 2400 HIV infections, at a cost of approximately US$7000 per HIV infection averted. Sensitivity analyses demonstrate that the use of alternative assumptions does not change the study conclusions. CONCLUSION: Our analyses suggest that expanding MMT is cost-effective, and support government policies to make MMT widely available as an integrated component of HIV/AIDS control in West Java.
This item appears in the following Collection(s)
- Academic publications [238441]
- Electronic publications [122538]
- Faculty of Medical Sciences [90373]
- Open Access publications [97530]
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