Community-based delivery of HIV treatment in Zambia not cost saving
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Community-based delivery of HIV treatment in Zambia not cost saving Community-based delivery of HIV treatment is more costly than conventional, clinic-based care, according to a study conducted in Zambia. The study estimated the annual cost per patient treated and per patient retained on antiretroviral therapy (ART) for four community-based differentiated service delivery (DSD) models (community adherence groups [CAGs]; mobile ART; urban adherence groups [UAGs]; and home ART delivery), compared with facility-based conventional care, for patients in Zambia considered stable on ART. The study was conducted between January 2015 through December 2017. The analysis of data from 2506 patients from 20 healthcare facilities (13 with DSD models and 7 providing conventional care) showed that the costs per patient treated were higher for any of the DSD models than for conventional care. The mean total annual costs per patient treated ranged from $US122 for mobile ART to $186 for home ART delivery, compared with $100 for conventional care (year 2018 values). UAG and CAG models had higher 12-month retention rates than conventional care (95% and 83%, respectively, vs 81%), whereas 12-month retention rates were lower for home ART delivery and mobile ART (79% and 69%, respectively). The mean costs per patient retained on ART at 12 months were higher in all DSD models, ranging from $157 for CAGs to $235 for home ART delivery, compared with $124 for conventional care. "Out-of-facility models of ART delivery that do not reduce the number of healthcare system interactions made by patients should be expcted to be more expensive than conventional, facility-based care," conclude the researchers. Nichols BE, et al. Community-based delivery of HIV treatment in Zambia: costs and outcomes. AIDS : 5 Nov 2020. Available from: URL: http://doi.org/10.1097/ QAD.0000000000002737
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PharmacoEconomics & Outcomes News 28 Nov 2020 No. 867
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