Updates of Lifetime Costs of Care and Quality-of-Life Estimates for HIV-Infected Persons in the United States

Farnham, Paul G.; Gopalappa, Chaitra; Sansom, Stephanie L.; Hutchinson, Angela B.; Brooks, John T.; Weidle, Paul J.; Marconi, Vincent C.; Rimland, David

doi:10.1097/qai.0b013e3182973966

Cited by 121 publications

(103 citation statements)

References 38 publications

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“…ICERs per AHI diagnosis for EarlyTest compared with Determine (III) and for the 3 algorithms that detect AHI (ie, EarlyTest, Architect, and Determine) compared with Antibody (IV) alone are displayed in Table 2 and Figure 2. EarlyTest was cost-savings compared with the other 3 algorithms, Architect was cost-savings when compared with Determine (ICER $14,776.50) and Antibody, and Determine was cost-savings when compared with Antibody [36]. ICERs per AHI when assuming a lower proportion of AHI cases (10% of all new HIV diagnoses) are depicted in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Costs per Diagnosis of Acute HIV Infection in Community-based Screening Strategies: A Comparative Analysis of Four Screening Algorithms

Hoenigl

Graff-Zivin

2015

Clin Infect Dis.

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Background. In nonhealthcare settings, widespread screening for acute human immunodeficiency virus (HIV) infection (AHI) is limited by cost and decision algorithms to better prioritize use of resources. Comparative cost analyses for available strategies are lacking.Methods. To determine cost-effectiveness of community-based testing strategies, we evaluated annual costs of 3 algorithms that detect AHI based on HIV nucleic acid amplification testing (EarlyTest algorithm) or on HIV p24 antigen (Ag) detection via Architect (Architect algorithm) or Determine (Determine algorithm) as well as 1 algorithm that relies on HIV antibody testing alone (Antibody algorithm). The cost model used data on men who have sex with men (MSM) undergoing community-based AHI screening in San Diego, California. Incremental cost-effectiveness ratios (ICERs) per diagnosis of AHI were calculated for programs with HIV prevalence rates between 0.1% and 2.9%.Results. Among MSM in San Diego, EarlyTest was cost-savings (ie, ICERs per AHI diagnosis less than $13.000) when compared with the 3 other algorithms. Cost analyses relative to regional HIV prevalence showed that EarlyTest was cost-effective (ie, ICERs less than $69.547) for similar populations of MSM with an HIV prevalence rate >0.4%; Architect was the second best alternative for HIV prevalence rates >0.6%.Conclusions. Identification of AHI by the dual EarlyTest screening algorithm is likely to be cost-effective not only among at-risk MSM in San Diego but also among similar populations of MSM with HIV prevalence rates >0.4%.

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Section: Resultsmentioning

confidence: 99%

Costs per Diagnosis of Acute HIV Infection in Community-based Screening Strategies: A Comparative Analysis of Four Screening Algorithms

Hoenigl

Graff-Zivin

2015

Clin Infect Dis.

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“…At a macro level, individuals who know they are HIV positive tend to reduce their unprotected encounters, thereby reducing the costs associated with treating additional HIV positive patients. The lifetime cost for a HIV patient with ≤ 200 CD4 T cells/μl is $253,000 compared to patients with 501 -900 CD T cells/μl is $402,000 [11]. Early diagnosis and treatment of HIV infection increases lifetime costs but additional life years from 30.8 to 38.1 for patients with late and early detection, respectively [11].…”

Section: Resultsmentioning

confidence: 99%

HIV Rapid Testing in a VA Primary Care Department Setting: Programmatic Cost Analysis at Five Years

Knapp¹,

Chan²

2015

J AIDS Clin Res

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“…In the early HAART era, economic analyses predominantly focused on establishing the costeffectiveness of HAART and various competing medication regimens [12]. In the past 10 years, attention has turned to determining the requisite scope and frequency of HIV testing [13,14], as well as the timing of HAART initiation [15,16], and the comparison of prevention strategies, including condom distribution, male circumcision, and treatment for both the infected and uninfected (i.e., pre-exposure prophylaxis) [17].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness Analysis Along the Continuum of HIV Care: How Can We Optimize the Effect of HIV Treatment as Prevention Programs?

et al. 2014

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The cascade of HIV care has been proposed as a useful tool to monitor health system performance across the key stages of HIV care delivery to reduce morbidity, mortality, and HIV transmission, the focal points of HIV Treatment as Prevention campaigns. Interventions to improve the cascade at its various stages may vary substantially in their ability to deliver health value per amount expended. In order to meet global antiretroviral treatment access targets, there is an urgent need to maximize the value of health spending by prioritizing cost-effective interventions. We executed a literature review on economic evaluations of interventions to improve specific stages of the cascade of HIV care. In total, 33 articles met the criteria for inclusion in the review, 22 (67 %) of which were published within the last 5 years. Nonetheless, substantial gaps in our knowledge remain, particularly for interventions to improve linkage and retention in HIV care in developed and developing-world settings and generalized and concentrated epidemics. We make the case here that the attention of scientists and policymakers needs to turn to the development, implementation, and rigorous evaluation of interventions to improve the various stages of the cascade of HIV care.

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Updates of Lifetime Costs of Care and Quality-of-Life Estimates for HIV-Infected Persons in the United States

Abstract: Early diagnosis and treatment of HIV infection increases lifetime costs but improves length and quality of life and reduces the number of new infections transmitted by nearly 50%.

Cited by 121 publications

References 38 publications

Costs per Diagnosis of Acute HIV Infection in Community-based Screening Strategies: A Comparative Analysis of Four Screening Algorithms

Costs per Diagnosis of Acute HIV Infection in Community-based Screening Strategies: A Comparative Analysis of Four Screening Algorithms

HIV Rapid Testing in a VA Primary Care Department Setting: Programmatic Cost Analysis at Five Years

Cost-effectiveness Analysis Along the Continuum of HIV Care: How Can We Optimize the Effect of HIV Treatment as Prevention Programs?

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