Evidence on the cost-effectiveness of lifelong antiretroviral therapy for prevention of motherto- child transmission of HIV: implications for resource-limited countries in sub-Saharan Africa

Research output: Contribution to journalArticle

  • External authors:
  • Aubrey Chichoni kalungia
  • Michael R Law
  • Francis Kaleemera
  • IIse Truter
  • Brian Goodman
  • Derick Munkombwe


Introduction: The 2016 World Health Organization (WHO) consolidated guideline recommends lifelong antiretroviral therapy (ART) for all HIV-infected pregnant and breastfeeding women for preventing mother-to-child HIV transmission (PMTCT). Ambiguity remains about the cost-effectiveness of this strategy in resource-limited developing countries.
Areas covered: We reviewed model-based studies on the cost-effectiveness of lifelong ART (formerly Option B+) relative to previous WHO guidelines for PMTCT. Our search using PubMed, Medline and Google Scholar for articles on Option B+ resulted in the final inclusion of seven studies published
between 2012 and 2016. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to assess the quality of reporting. Outcomes of interest, which included infant infections averted, maternal quality and length of life, and the Incremental Cost Effectiveness Ratio
(ICER), were used in comparing cost-effectiveness. Expert commentary: Despite most model-based studies favouring lifelong ART (Option B+) in terms of
its cost-effectiveness in comparison to Options A and B, inclusiveness of the evidence remains weak for generalization. This is largely because setting specificity for providing lifelong ART to all pregnant and breastfeeding women may differ significantly in each setting. Consequently, future cost-effectiveness
studies should be robust, setting-specific, and endeavor to assess the willingness and ability to pay of each setting.

Bibliographical metadata

Original languageEnglish
JournalExpert Rev Pharmacoecon Outcomes Res
Early online date11 Aug 2017
Publication statusPublished - 11 Aug 2017