OBJECTIVES: To investigate the cost-utility of conducting human immunodeficiency virus (HIV) screening using different approaches (status quo vs. a rapid polymerase chain reaction [PCR] test, or the traditional method) in an HIV high-risk province in China from a patient's perspective.

METHODS: Using Sichuan province as the base target population, a cost-utility analysis model (CUA) was developed to assess the incremental cost-effectiveness ratios (ICER) of a rapid PCR test (diagnosis+viral load) vs. the traditional method (screening+Western blot [confirmatory]+viral load) or the status quo. The ICERs were calculated by dividing the incremental HIV-related healthcare costs by the incremental quality-adjusted life years (QALY). The model evaluated testing fees, supportive care costs, costs of antiretroviral therapy, and costs of laboratory tests. The testing fees of the traditional method and costs of additional diagnostic tests (to rule out other diseases) were applied to the status quo to account for the consequence of delayed diagnosis. Costs were estimated in the 2022 Chinese yuan. Model inputs, such as healthcare costs, prevalence of HIV, and HIV-related utility, were obtained from published sources or expert opinions. In the base case, the percentage of newly diagnosed HIV was 1%.

RESULTS: In the base case, 1,600 HIV patients were newly identified from a high-risk population of 200,000 people in the Sichuan province. The rapid PCR test was more cost effective compared with the traditional approach (ICER dominant, 1.65 QALY gained by￥1,490 fewer costs) and the status quo (ICER dominant, 1.86 QALY gained by￥2,004 fewer costs).

CONCLUSIONS: Introducing an HIV screening program could identify more HIV patients with no or mild symptoms compared to the status quo. Furthermore, utilizing a rapid PCR test provides a more cost-effective way to help HIV patients gain more QLAY by reducing the waiting time before receiving test results compared to the traditional method.