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

Peslie G. Ngambi, Aubrey C. Kalungia, Michael R. Law, Francis Kalemeera, Ilse Truter, Brian Godman, Derick Munkombwe

Research output: Contribution to journalArticle

3 Citations (Scopus)
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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 cost-effectiveness in comparison to Options A and B, inclusiveness of the evidence remains weak for generalization largely because setting specificity for providing lifelong ART to all pregnant and breastfeeding women may differ significantly in each setting. Therefore, future cost-effectiveness studies should be robust, setting-specific, and endeavor to assess the willingness and ability to pay of each setting.
Original languageEnglish
Pages (from-to)459-467
Number of pages9
JournalExpert Review of Pharmacoeconomics and Outcomes Research
Issue number5
Early online date3 Aug 2017
Publication statusPublished - 11 Aug 2017


  • cost-effectiveness
  • antiretroviral therapy
  • Option B+
  • modelling
  • mother-to-child transmission
  • implications
  • resource-limited countries
  • HIV

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