The Cost and Threshold Analysis of Retention in Care (RiC): A Multi-Site National HIV Care Program

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• 作者：Catherine Maulsby ; Kriti M. Jain ; Brian W. Weir ; Blessing Enobun…
• 关键词：Cost analysis ; Threshold analysis ; Retention in HIV care
• 刊名：AIDS and Behavior
• 出版年：2017
• 出版时间：March 2017
• 年：2017
• 卷：21
• 期：3
• 页码：643-649
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Public Health; Health Psychology; Infectious Diseases;
• 出版者：Springer US
• ISSN：1573-3254
• 卷排序：21

文摘

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.