The objective of this study was to understand the approximate upper limit of cost that could be considered for interventions to measure medication adherence to antiretroviral drugs for HIV 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.
The study found that: 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, depending on whether the adherence intervention is used to reduce the level of need for viral load measurement.
In Conclusion: The cost thresholds identified suggest that there is clear scope for adherence monitoring-based interventions to provide net population health gain, with potential cost-effective use in situations where viral load monitoring is or is not available. Our results guide the implementation of future adherence monitoring interventions found in randomized trials to have health benefit.
Tags: Cost Effectiveness, PLoS One, Phillips
Full Citation: Phillips, A. N., Cambiano, V., Nakagawa, F., Bansi-Matharu, L., Sow, P. S., Ehrenkranz, P., . . . Revill, P. (2016). Cost Effectiveness of Potential ART Adherence Monitoring Interventions in Sub-Saharan Africa. PLoS One, 11(12), e0167654. doi:10.1371/journal.pone.0167654