Bulletin of the World Health Organization

The incremental cost of switching from Option B to Option B+ for the prevention of mother-to-child transmission of HIV

Lisa O’Brien, Nathan Shaffer, Nalinee Sangrujee & Taiwo O Abimbola

Volume 92, Number 3, March 2014, 162-170

Table 3. Incremental costa per woman of Option B+b relative to Option Bc over 5 years postpartum

Breastfeeding status and duration CD4+ count 350–500 cells/µl
CD4+ count > 500 cells/µl
Total cost Option B+ Total cost Option B Incremental cost Total cost Option B+ Total cost Option B Incremental cost
Breastfeeding
12 months 2069 1814 255 2069 1261 808
18 months 2069 1814 255 2069 1362 707
24 months 2069 1814 255 2069 1463 606
No breastfeeding 2069 1915 154 2069 1059 1010

a All costs are given in 2011 United States dollars.

b Option B+ comprises a triple antiretroviral (ARV) regimen initiated during pregnancy and continued for life.

c Option B comprises a maternal triple ARV regimen, typically consisting of the recommended first-line antiretroviral therapy (ART), during pregnancy and throughout breastfeeding, in combination with 6 weeks of daily nevirapine for the infant, regardless of infant feeding method.

Note: Within each CD4+ cell count stratum, the time to ART treatment eligibility was the same regardless of breastfeeding duration; however, the time in treatment varied across breastfeeding duration categories.