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 4. Incremental costa per 1000 women 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 2 068 627 1 911 282 157 345 2 068 627 1 584 036 484 591
18 months 2 068 627 1 911 282 157 345 2 068 627 1 644 609 424 017
24 months 2 068 627 1 911 282 157 345 2 068 627 1 705 183 363 443
No breastfeeding 2 068 627 1 975 814 92 813 2 068 627 1 462 888 605 739

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 ARV regimen, typically consisting of the recommended first-line antiretroviral therapy, 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 eligibility was the same regardless of breastfeeding duration; however, the time in treatment varied across breastfeeding duration categories.