National HIV Prevention Conference Atlanta, Georgia, USA — July 27 - 30, 2003

Natl HIV Prev Conf 2003 July 27-30:abstract no. M1-E0603
Scotton CR, Wen X
CDC, Atlanta, GA

ISSUE: Considering cost-effectiveness has long been a goal in determining priorities for HIV prevention and the Institute of Medicine report, No Time to Lose: Getting More From HIV Prevention, recommended adopting cost-effectiveness principles in the allocation of HIV prevention resources. While the literature on the cost-effectiveness of specific interventions and of prevention in general continues to grow, turning this research into practice has been difficult. Beyond the critical need for information on interventions with known effectiveness (and the ability for communities to replicate these), a host of unresolved issues in conducting appropriate cost analysis remains.

SETTING: Decision makers, advocates, and planners at the state and local level involved in the community planning process.

PROJECT: A literature review on the practical use of cost-effectiveness and extensive subject matter interviews done in preparation for developing tools and models to incorporate cost-effectiveness into HIV prevention community planning.

RESULTS: Differences in how cost data must be treated depends upon how it will be used. Costs used to estimate a cost-effectiveness ratio (CER) account for all resources, regardless of their price, in order to make valid comparisons between possible alternatives. The CER does not contain information about the number of people to be reached or that could be served with a particular budget. In determining the allocation of HIV prevention funds, however, specific information is needed on prices and quantities of the resources necessary to provide a particular service (or package of services) to an individual, including information on fixed and variable costs. There are critical underlying assumptions inherent, but often misunderstood, in analyzing and interpreting cost and cost-effectiveness data.

LESSONS LEARNED: Using information about costs and cost-effectiveness from the literature requires translation and can only be used effectively when many non-obvious assumptions and factors are understood. As more emphasis is placed on using resources efficiently, policy makers as well as administrators and program planners must approach this information knowledgeably.

030727
M1-E0603

Copyright notice: The National HIV Prevention Conference is collaborative effort by the Centers for Disease Control and Prevention, a U.S. Government agency and other governmental and non-government organizations. All abstracts published in by the conference organizers are in the public domain and can be used without permission. Proper citation, however, is required.