دورية أكاديمية
Cost Effectiveness of Potential ART Adherence Monitoring Interventions in Sub-Saharan Africa
| العنوان: | Cost Effectiveness of Potential ART Adherence Monitoring Interventions in Sub-Saharan Africa |
|---|---|
| المؤلفون: | Phillips, AN, Cambiano, V, Nakagawa, F, Bansi-Matharu, L, Sow, PS, Ehrenkranz, P, Ford, D, Mugurungi, O, Apollo, T, Murungu, J, Bangsberg, DR, Revill, P |
| المصدر: | PLOS ONE , 11 (12) , Article e0167654. (2016) |
| بيانات النشر: | PUBLIC LIBRARY SCIENCE |
| سنة النشر: | 2016 |
| المجموعة: | University College London: UCL Discovery |
| مصطلحات موضوعية: | Science & Technology, Multidisciplinary Sciences, Science & Technology - Other Topics, ACTIVE ANTIRETROVIRAL THERAPY, MIDDLE-INCOME COUNTRIES, DRUG-RESISTANCE, VIROLOGICAL FAILURE, SOUTH-AFRICA, VIRAL LOAD, HIV CARE, COHORT, PATTERNS, PEOPLE |
| الوصف: | BACKGROUND: Interventions based around objective measurement of adherence to antiretroviral drugs for HIV have potential to improve adherence and to enable differentiation of care such that clinical visits are reduced in those with high adherence. It would be useful to understand the approximate upper limit of cost that could be considered for such interventions of a given effectiveness in order to be cost effective. Such information can guide whether to implement an intervention in the light of a trial showing a certain effectiveness and cost. METHODS: An individual-based model, calibrated to Zimbabwe, which incorporates effects of adherence and resistance to antiretroviral therapy, was used to model the potential impact of adherence monitoring-based interventions on viral suppression, death rates, disability adjusted life years and costs. Potential component effects of the intervention were: enhanced average adherence when on ART, reduced risk of ART discontinuation, and reduced risk of resistance acquisition. We considered a situation in which viral load monitoring is not available and one in which it is. In the former case, it was assumed that care would be differentiated based on the adherence level, with fewer clinic visits in those demonstrated to have high adherence. In the latter case, care was assumed to be primarily differentiated according to viral load level. The maximum intervention cost required to be cost effective was calculated based on a cost effectiveness threshold of $500 per DALY averted. FINDINGS: In the absence of viral load monitoring, an adherence monitoring-based intervention which results in a durable 6% increase in the proportion of ART experienced people with viral load < 1000 cps/mL was cost effective if it cost up to $50 per person-year on ART, mainly driven by the cost savings of differentiation of care. In the presence of viral load monitoring availability, an intervention with a similar effect on viral load suppression was cost-effective when costing $23-$32 per year, ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| العلاقة: | https://discovery.ucl.ac.uk/id/eprint/1533174/1/Nakagawa_2016%20-%20phillips%20-%20ce%20adherence%20monitoring%20interventions.pdfTest; https://discovery.ucl.ac.uk/id/eprint/1533174Test/ |
| الإتاحة: | https://discovery.ucl.ac.uk/id/eprint/1533174/1/Nakagawa_2016%20-%20phillips%20-%20ce%20adherence%20monitoring%20interventions.pdfTest https://discovery.ucl.ac.uk/id/eprint/1533174Test/ |
| حقوق: | open |
| رقم الانضمام: | edsbas.4012A90A |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |