Læknablaðið - 01.07.2014, Blaðsíða 15

LÆKNAblaðið 2014/100 383
ENGLISH SUMMARY
Objective: In 2007 there was a sudden increase in HIV cases among
intravenous drug users (IDUs) in Iceland. In 2007 - 2011 there were
34 new HIV cases among IDUs compared to four in the previous four
year period. The purpose of this study was to assess whether needle
exchange programs (NEPs) were cost-effective in preventing the spread
of HIV among IDUs in Iceland.
Materials and methods: Cost-utility analysis was conducted from a
societal perspective. Costs are presented at the 2011 price level and
values were discounted using a 3% discount rate. A ten year period,
2011 - 2020 was compared with and without NEPs. The Incremental
Cost-Utility Ratio (ICUR) was calculated as societal cost per quality
adjusted life year (QALY). Sensitivity analysis was performed on study
assumptions.
Results: The estimated societal costs associated with HIV infections
among IDUs from 2011 - 2020 was 914.369.621 ISK without NEP
and 947.653.758 ISK with NEP. Excess societal cost due to NEP was
33.284.137 ISK. Societal utility from NEP was 7,39 QALYs. Additionally,
NEP prevented 4-5 HIV infections. The ICUR of providing NEP was
4.506.720 ISK.
Conclusion: According to WHO an intervention is considered cost-
effective if the ICUR is less than three-fold national GDP per capita. In
2011 the GDP per capita in Iceland was 15.315.000 ISK. Sensitivity ana-
lysis on study assumptions yielded a societal cost within the WHO limit.
Therefore, the results indicate that NEPs are cost-effective in preventing
the spread of HIV among IDUs in Iceland.
key words: HIV, intravenous drug use, cost-utility analysis.
Correspondence: Magnús Gottfreðsson, magnusgo@landspitali.is
1Faculty of Medicine, University of Iceland, 2Department of economics, University of Iceland, 3Department of infectious diseases, Landspitali University Hospital, Reykjavik, Iceland.
Needle Exchange Programs are a cost-effective preventative measure against HIV in Iceland
Elias Sæbjörn Eyþorsson1, Tinna Laufey Asgeirsdottir2, Magnus Gottfredsson3
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