Using cost-effectiveness league tables to compare interventions to preventsexual transmission of HIV

Cost-effectiveness information is needed to help public health decision mak ers choose between competing HIV prevention programs. One way to organize t his information is in a 'league table' that lists cost-effectiveness ratios for different interventions and which facilitates comparisons across inter ventions. Herein we propose a common outcome measure for use in HIV prevent ion league tables and present a preliminary league table of interventions t o reduce sexual transmission of HIV in the US. Fifteen studies encompassing 29 intervention for different population groups are included in the table. Approximately half of the interventions are cost-saving (i.e, save society money, in the long run), and three-quarters are cost-effective by conventi onal standards. We discuss the utility of such a table for informing the HI V prevention resource allocation process and delineate some of the difficul ties associated with the league table approach, especially as applied to HI V prevention cost-effectiveness analysis. (C) 2001 Lippincott Williams & Wi lkins.