Modeling zidovudine therapy: a cost-effectiveness analysis.

Zidovudine (ZDV), the first FDA-approved therapy for HIV/AIDS, poses a dilemma to the policymaker. On the one hand, ZDV extends the life of HIV-infected persons, producing a clear benefit. On the other hand, some fear that prolonging the lives of infected individuals may contribute to the increased spread of the virus and to a steep rise in the overall costs of AIDS to society. To address this issue, we present a simple model of ZDV therapy against a backdrop of HIV transmission in a population of sexually active, gay men. We find no basis for the fear of dramatic increases in the incidence of AIDS or its associated costs among gay men due to widespread ZDV distribution. On the contrary, our analysis suggests that ZDV therapy is cost-effective, particularly when it is accompanied by modest efforts to promote behavior change and prevention.