In AIDS (London, England)
OBJECTIVES : Crowdsourcing, which taps into the wisdom of crowds, has been successful in generating strategies to enhance HIV self-testing (HIVST) uptake. We determined the cost-effectiveness of a crowdsourced intervention (one-off or annual) compared to a control scenario (no crowdsourcing) among men who have sex with men (MSM) living in China.
DESIGN : Economic evaluation.
METHODS : We used data from our cluster randomized controlled trial of MSM (NCT02796963). We used a micro-costing approach to measure direct health costs ($USD2017) from a health provider perspective. Using outputs from a dynamic transmission model over a 20-year time horizon, we estimated the incremental cost-effectiveness ratios (ICER) using cost per disability adjusted life years (DALYs) averted with 3% discounting. An intervention was considered highly cost-effective if it was less than one gross domestic product (GDP, $8,823) per DALY averted.
RESULTS : Across all cities, the crowdsourced intervention was highly cost-effective compared to the control scenario (ICER ranged from $2,263 to 6,152 per DALY averted for annual crowdsourcing; $171 to 204 per DALY averted for one-off crowdsourcing). The one-off intervention was cost-saving in Guangzhou and Qingdao. Sensitivity analyses confirmed the robustness of the findings; specifically, changes in discounting, costs of the crowdsourced intervention, costs of HIV testing and cost of ART did not alter our conclusions.
CONCLUSIONS : Scaling up a one-off or annual crowdsourced HIV prevention intervention in four cities in China was very likely to be cost-effective. Further research is warranted to evaluate the feasibility of scaling up crowdsourced HIV prevention interventions in other settings and populations.
Ong Jason J, Booton Ross D, Tucker Joseph D, Tang Weiming, Vickerman Peter, Zhang Lei, Mitchell Kate M
2022-Dec-12
