BACKGROUND: The US Health Resources and Services Administration sponsored a 5-year initiative to test three types of counseling-based interventions to reduce HIV transmission among HIV-infected patients delivered in clinical settings. We assessed the cost and cost-effectiveness of the three types of interventions at 13 sites: primary care provider-based (clinical provider); social worker or peer educator-based (specialist); and a mix of primary care and specialist-based (mixed). METHODS: We developed a cost-effectiveness model to calculate average and incremental cost-effectiveness ratios and the cost-effectiveness of the 13 sites combined. RESULTS: Spending over all 3 years of the demonstration averaged $1004, $3173, and $3430 per client served for clinical provider, specialist, and mixed services, respectively. Unit costs declined with the volume of services provided for all three intervention types. The cost-effectiveness of the clinical provider sites was $107,656 per HIV case averted compared with no intervention. Clinical provider sites were less costly and more effective than the specialist or mixed sites. CONCLUSIONS: Compared with the lifetime cost of HIV/AIDS care and with other effective HIV prevention interventions, the clinical provider-led interventions in this study are cost-effective. In an incremental comparison with clinical provider sites, specialist and mixed intervention sites were not cost-effective.
BACKGROUND: The US Health Resources and Services Administration sponsored a 5-year initiative to test three types of counseling-based interventions to reduce HIV transmission among HIV-infectedpatients delivered in clinical settings. We assessed the cost and cost-effectiveness of the three types of interventions at 13 sites: primary care provider-based (clinical provider); social worker or peer educator-based (specialist); and a mix of primary care and specialist-based (mixed). METHODS: We developed a cost-effectiveness model to calculate average and incremental cost-effectiveness ratios and the cost-effectiveness of the 13 sites combined. RESULTS: Spending over all 3 years of the demonstration averaged $1004, $3173, and $3430 per client served for clinical provider, specialist, and mixed services, respectively. Unit costs declined with the volume of services provided for all three intervention types. The cost-effectiveness of the clinical provider sites was $107,656 per HIV case averted compared with no intervention. Clinical provider sites were less costly and more effective than the specialist or mixed sites. CONCLUSIONS: Compared with the lifetime cost of HIV/AIDS care and with other effective HIV prevention interventions, the clinical provider-led interventions in this study are cost-effective. In an incremental comparison with clinical provider sites, specialist and mixed intervention sites were not cost-effective.
Authors: Stephen F Morin; Jeffrey A Kelly; Edwin D Charlebois; Robert H Remien; Mary J Rotheram-Borus; Paul D Cleary Journal: J Acquir Immune Defic Syndr Date: 2011-07-01 Impact factor: 3.731
Authors: Susan Dreisbach; Helen Burnside; Katherine Hsu; Laura Smock; Patricia Coury-Doniger; Christopher Hall; Jeanne Marrazzo; Gowri Nagendra; Cornelis Rietmeijer; Ann Rompalo; Mark Thrun Journal: AIDS Patient Care STDS Date: 2014-01 Impact factor: 5.078
Authors: Sabina Hirshfield; Martin J Downing; Jeffrey T Parsons; Christian Grov; Rachel J Gordon; Steven T Houang; Roberta Scheinmann; Patrick S Sullivan; Irene S Yoon; Ian Anderson; Mary Ann Chiasson Journal: JMIR Res Protoc Date: 2016-06-17