Maulsby Catherine, Jain Kriti M, Weir Brian W, Enobun Blessing, Riordan Maura, Charles Vignetta E, Holtgrave David R
Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, USA.
AIDS United, 1424 K Street, N.W., Washington, DC, 20005, USA.
AIDS Behav. 2017 Mar;21(3):643-649. doi: 10.1007/s10461-016-1623-3.
Persons diagnosed with HIV but not retained in HIV medical care accounted for the majority of HIV transmissions in 2009 in the United States (US). There is an urgent need to implement and disseminate HIV retention in care programs; however little is known about the costs associated with implementing retention in care programs. We assessed the costs and cost-saving thresholds for seven Retention in Care (RiC) programs implemented in the US using standard methods recommended by the US Panel on Cost-effectiveness in Health and Medicine. Data were gathered from accounting and program implementation records, entered into a standardized RiC economic analysis spreadsheet, and standardized to a 12 month time frame. Total program costs for from the societal perspective ranged from $47,919 to $423,913 per year or $146 to $2,752 per participant. Cost-saving thresholds ranged from 0.13 HIV transmissions averted to 1.18 HIV transmission averted per year. We estimated that these cost-saving thresholds could be achieved through 1 to 16 additional person-years of viral suppression. Across a range of program models, retention in care interventions had highly achievable cost-saving thresholds, suggesting that retention in care programs are a judicious use of resources.
2009年在美国，被诊断出感染艾滋病毒但未接受艾滋病毒医疗护理的人占艾滋病毒传播的大多数。迫切需要实施并推广艾滋病毒护理留存项目；然而，对于实施护理留存项目的相关成本却知之甚少。我们使用美国卫生与医学成本效益小组推荐的标准方法，评估了美国实施的七个护理留存（RiC）项目的成本和成本节约阈值。数据从会计和项目实施记录中收集，输入到标准化的RiC经济分析电子表格中，并标准化为12个月的时间框架。从社会角度来看，每个项目每年的总成本从47,919美元到423,913美元不等，即每位参与者每年146美元到2,752美元。成本节约阈值为每年避免0.13例至1.18例艾滋病毒传播。我们估计，通过额外1至16个人年的病毒抑制可实现这些成本节约阈值。在一系列项目模式中，护理留存干预措施的成本节约阈值很容易实现，这表明护理留存项目是对资源的明智利用。
