@article {1523, title = {Cost-effectiveness of an intervention to improve adherence to antiretroviral therapy in HIV-infected patients.}, journal = {Journal of acquired immune deficiency syndromes (1999)}, volume = {43 Suppl 1}, year = {2006}, month = {2006 Dec 1}, pages = {S113-8}, abstract = {Adherence to antiretroviral medications has been shown to be an important factor in predicting viral suppression and clinical outcomes. The objective of this analysis was to assess the cost-effectiveness of a nursing intervention on antiretroviral adherence using data from a randomized controlled clinical trial as input to a computer-based simulation model of HIV disease. For a cohort of HIV-infected patients similar to those in the clinical trial (mean initial CD4 count of 319 cells/mm), implementing the nursing intervention in addition to standard care yielded a 63\% increase in virologic suppression at 48 weeks. This produced increases in expected survival (from 94.5 to 100.9 quality-adjusted life months) and estimated discounted direct lifetime medical costs ($253,800 to $261,300). The incremental cost-effectiveness ratio for the intervention was $14,100 per quality-adjusted life year gained compared with standard care. Adherence interventions with modest effectiveness are likely to provide long-term survival benefit to patients and to be cost-effective compared with other uses of HIV care funds.}, keywords = {Adult, Anti-HIV Agents, Computer Simulation, Cost-Benefit Analysis, Female, Health Care Costs, HIV Infections, Humans, Male, Middle Aged, Models, Statistical, Patient Compliance, Sensitivity and Specificity}, issn = {1525-4135}, doi = {10.1111/j.1524-4733.2010.00763.x}, author = {Freedberg, Kenneth A and Hirschhorn, Lisa R and Schackman, Bruce R and Wolf, Lindsey L and Martin, Lindsay A and Weinstein, Milton C and Goldin, Susan and Paltiel, A David and Katz, Carol and Goldie, Sue J and Losina, Elena} }