Cost-benefit analysis of prevention of mother-to-child transmission of HIV services: a contingent valuation study of patients' preferences from clinical pharmacists' perspective

Objectives Cost-benefit analysis is the least reported economic analysis of prevention of motherto-child transmission services. In cost-benefit analysis, consumers' wellbeing is considered from their own perspective. This study determined the benefit-cost ratios of prevention of mother-to-child transmission services in two Nigerian tertiary hospitals. Methods This was a cross-sectional survey using willingness-to-pay. The study was conducted among patients at Ahmadu Bello University Teaching Hospital and the University of Nigeria Teaching Hospital. Potential benefit was measured as patients' willingness-to-pay while cost was measured from pharmacists' perspective. The benefit-cost ratio for each service was obtained as the average after 1000 iterations of Monte Carlo simulation in a probabilistic sensitivity analysis. Key findings Atotal of 219 patients responded to the questionnaires. Most of the patients were married, 149 (68.0%). Primary prevention of HIV had the highest 'yes' willingness-to-pay response of 152 (69.4%). It also had the highest mean willingness-to-pay amount of N7987.42 +/- 4542.00, with willingness-to-pay minimum (maximum) amounts of N100 (N500 000). Primary prevention of HIV had the highest return-on-investment for 15 min of hospital pharmacists' salary: benefit-cost ratio 19.286 +/- 0.170 (95% CI: 18.954-19.618). Conclusion Primary Prevention of HIV had the highest benefit-cost ratio among the six prevention of mother-to-child transmission services. This suggests that healthcare systems will have the highest return-on-investment if they asked patients to pay for the service.