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The Cost-Effectiveness of Preventing Cytomegalovirus Disease in AIDS Patients

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  • A. David Paltiel

    (Yale School of Medicine, 60 College Street, New Haven, Connecticut 06520-8034)

  • Kenneth A. Freedberg

    (Clinical Economics Research Unit, Section of General Internal Medicine, Department of Medicine and Thorndike Memorial Laboratory, Boston Medical Center, Boston University School of Medicine, 91 East Concord Street, Suite 200, Boston, Massachusetts 02118)

Abstract

To examine the costs and consequences of prophylaxis against cytomegalovirus (CMV) infection, we developed a compartmental model of the natural history of late-stage HIV disease. We used data on the progression of illness, economic costs, the incidence of infections, the efficacy and toxicity of therapy, and patient quality of life from national cohort studies, randomized clinical trials, and resource-utilization surveys. We found that CMV prophylaxis confers additional quality-adjusted life-years at a lower-bound, marginal cost of $160,000. While this cost-effectiveness result compares unfavorably with alternative uses of scarce resources, it is sensitive to assumptions regarding the price of therapy and the incidence of infection.

Suggested Citation

  • A. David Paltiel & Kenneth A. Freedberg, 1998. "The Cost-Effectiveness of Preventing Cytomegalovirus Disease in AIDS Patients," Interfaces, INFORMS, vol. 28(3), pages 34-51, June.
    • Handle: RePEc:inm:orinte:v:28:y:1998:i:3:p:34-51
    DOI: 10.1287/inte.28.3.34
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    References listed on IDEAS

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    1. Drummond, Michael & Mason, James & Torrance, George, 1995. "Cost-effectiveness league tables: think of the fans," Health Policy, Elsevier, vol. 31(3), pages 231-238, March.
    2. Torrance, George W., 1976. "Social preferences for health states: An empirical evaluation of three measurement techniques," Socio-Economic Planning Sciences, Elsevier, vol. 10(3), pages 129-136.
    3. George W. Torrance & Michael H. Boyle & Sargent P. Horwood, 1982. "Application of Multi-Attribute Utility Theory to Measure Social Preferences for Health States," Operations Research, INFORMS, vol. 30(6), pages 1043-1069, December.
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