Cost-effectiveness of methadone maintenance treatment in prevention of HIV among drug users in Shiraz, South of Iran

Abstract EN

Background : the increase in high-risk injections and unsafe sexual behaviors has led to increased HIV infection prevalence among Intravenous Drug Users (IDUs).

The high costs of HIV/AIDS care and low financial resources necessitate an economic evaluation to make the best decision for the control of HIV / AIDS.

Objectives : this study was conducted to determine the cost-effectiveness of Methadone Maintenance Treatment (MMT) centers in HIV infection prevention among drug users.

Materials and Methods: In this interventional study, we included all the seven MMT centers and the drug users registered there (n = 694).

We calculated all the costs imposed on the government, i.e.

Provider of case.

Mathematical models were used to estimate the number of HIV cases averted from high-risk behaviors.

Sensitivity analyses were performed to show the effects of uncertainty in parameters on the number of HIV cases averted and also Incremental Cost-Effectiveness Ratio (ICER).

Results : based on the averted models, the selected MMT centers could prevent 128 HIV cases during 1 year.

The total cost was $ 547423 and that of HIV/AIDS care in the no intervention scenario was estimated $ 14171816.

ICER was $ 106382 per HIV case averted.

The results of the sensitivity analysis indicated that MMT intervention was cost-effective even in the worst scenario and ICER varied from $ 39149 to $ 290004 per HIV case averted.

Conclusions : with regard to the high prevalence of drug injection among drug users and considering the high effectiveness and cost-effectiveness of MMT centers in preventing HIV infection, establishment of MMT centers in regional and national levels seems reasonable.