Cost-effectiveness and Cost-utility of the Adherence Improving Self-management Strategy in Human Immunodeficiency Virus Care: A Trial-based Economic Evaluation

Abstract

Base case analyses suggests that over a period of 15 months, AIMS may be costlier, but also more effective than TAU. All additional analyses suggest that AIMS is cheaper and more effective than TAU. This trial-based economic evaluation confirms and complements a model-based economic evaluation with a lifetime horizon showing that AIMS is cost-effective.

Are intersectoral costs considered in economic evaluations of interventions relating to sexually transmitted infections (STIs)? A systematic review

“…However, not all studies explicitly stated whether they applied a CEA or CUA approach. Only three out of the 29 studies explicitly reported to have undertaken a CUA [ 35 – 37 ] and one study was explicit about having conducted both a CEA and CUA [ 38 ]. Modelling was used in all but two studies, which were trial-based [ 36 , 37 ].…”

“…Vaccination and screening interventions dominated, and involved stand-alone vaccination [ 45 , 50 – 52 ], vaccination in addition to screening [ 40 , 53 – 56 ], vaccination of girls and boys [ 43 , 47 ], sex-neutral vaccination [ 49 ], screening (stand-alone) [ 41 , 57 – 59 ], screening in addition to testing [ 60 ] and screening after vaccination [ 61 ]. Other interventions involved test and treat interventions including PrEP (Pre-Exposure Prophylaxis) [ 42 , 62 ], testing and linkage to care [ 37 ] and opt-out testing strategy [ 46 ]; expedited partner treatment [ 46 ], population-level treatment expansion [ 44 ], (on-demand) PrEP [ 35 , 63 ], treatment adherence interventions [ 38 ], guided internet-based behaviour intervention [ 36 ] and financial incentives [ 39 ].…”

“…Caregiver support (non-family) and unpaid help by family/friends was captured in four studies [ 38 , 42 , 52 , 56 ]. Two focused on informal care costs related to HIV/AIDS care [ 38 , 42 ], one on caregiver time loss during treatment for cervical cancer patients [ 52 ] and one estimated the time taken by family members during patients’ palliative care due to hepatitis B-related cancer [ 56 ].…”

“…Only four studies explicitly reported capturing the costs associated with non-paid work (i.e. domestic tasks, voluntary work) [ 36 , 38 , 39 , 52 ]. It was not clear if/how many studies equated non-paid opportunity costs (i.e.…”

“…School absence was captured in one study only [ 38 ]. It refers to an individual missing out on potential productivity and educational attainment, but no further characteristics were stated for those who missed school.…”