Table 1.
Selected model input parameters.
Fig 1.
Maternal care cascade through 10 years postpartum.
Projected outcomes for the starting maternal cohort at 1, 5, and 10 years postpartum are shown for the standard of care (SOC; left bar) and MCH-ART (right bar) strategies. Cumulative maternal mortality at each time point is demonstrated by the checkered black (while lost to follow-up) and gray grid (while in care) sections. Among mothers alive at 1 year, 5 years, and 10 years, those lost to follow-up (red, diagonal lines), in care and not virologically suppressed (solid yellow), and in care and virologically suppressed (green, dotted) are depicted.
Table 2.
Base case results.
Fig 2.
Tornado diagram of one-way sensitivity analyses.
Results of one-way sensitivity analyses of 8 key model input parameters (vertical axis) are shown. The ICER ($/YLS) of MCH-ART compared to SOC is displayed along the horizontal axis. Base case inputs for each varied parameter are listed prior to the semicolon; after the semicolon is the range examined with the first value indicating the value of the left-most part of the bar. Parameters were varied through the range listed (S2 Table details rationale for ranges), with the input that contributes to the lowest ICER for the range listed first. The thick black vertical line marks the base case ICER ($599/YLS). The dotted line represents the cost-effectiveness threshold ($903/YLS; see text). Numbers in white reflect the value at which parameters crossed the cost-effectiveness threshold. ICER: incremental cost-effectiveness ratio; ART: antiretroviral therapy; LTFU: loss to follow-up; YLS: year of life saved.
Fig 3.
Multi-way sensitivity analyses.
In panels A and B, the proportion of mothers retained in care at 12-months in MCH-ART is demonstrated on the vertical axis and the proportion of virologically suppressed mothers among those retained in care in MCH-ART is shown on the horizontal axis. Without commensurate improvements in suppression, increasing retention alone results in MCH-ART being no longer cost-effective (yellow). MCH-ART was cost-effective at a wider range of combinations of maternal retention and virologic suppression among mothers retained in care with MCH-ART postpartum healthcare costs at $69 (A, base case costs) compared to $138 (B, 2x base case costs). ICER: incremental cost-effectiveness ratio; SOC: standard of care; YLS: year of life saved.