Jain Kriti M, Maulsby Catherine, Brantley Meredith, Kim Jeeyon Janet, Zulliger Rose, Riordan Maura, Charles Vignetta, Holtgrave David R
a Department of Health, Behavior, and Society , The Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
b AIDS United , Washington , DC , USA.
AIDS Care. 2016 Sep;28(9):1199-204. doi: 10.1080/09540121.2016.1164294. Epub 2016 Mar 28.
Out of >1,000,000 people living with HIV in the USA, an estimated 60% were not adequately engaged in medical care in 2011. In response, AIDS United spearheaded 12 HIV linkage and retention in care programs. These programs were supported by the Social Innovation Fund, a White House initiative. Each program reflected the needs of its local population living with HIV. Economic analyses of such programs, such as cost and cost threshold analyses, provide important information for policy-makers and others allocating resources or planning programs. Implementation costs were examined from societal and payer perspectives. This paper presents the results of cost threshold analyses, which provide an estimated number of HIV transmissions that would have to be averted for each program to be considered cost-saving and cost-effective. The methods were adapted from the US Panel on Cost-effectiveness in Health and Medicine. Per client program costs ranged from $1109.45 to $7602.54 from a societal perspective. The cost-saving thresholds ranged from 0.32 to 1.19 infections averted, and the cost-effectiveness thresholds ranged from 0.11 to 0.43 infections averted by the programs. These results suggest that such programs are a sound and efficient investment towards supporting goals set by US HIV policy-makers. Cost-utility data are pending.
在美国超过100万的艾滋病毒感染者中，估计2011年有60%没有充分接受医疗护理。作为回应，“艾滋病联合组织”率先开展了12个艾滋病毒关联及护理维持项目。这些项目得到了白宫发起的社会创新基金的支持。每个项目都反映了当地艾滋病毒感染者的需求。对此类项目的经济分析，如成本和成本阈值分析，为政策制定者及其他资源分配者或项目规划者提供了重要信息。从社会和付款人的角度审视了实施成本。本文介绍了成本阈值分析的结果，该分析提供了每个项目为实现成本节约和成本效益而必须避免的艾滋病毒传播估计数量。这些方法改编自美国卫生与医学成本效益小组。从社会角度来看，每个客户的项目成本从1109.45美元到7602.54美元不等。成本节约阈值为避免0.32至1.19例感染，成本效益阈值为这些项目避免0.11至0.43例感染。这些结果表明，此类项目是对支持美国艾滋病毒政策制定者设定目标的合理且高效的投资。成本效用数据尚未得出。
