| Title | Cost-effectiveness of an intervention to improve adherence to antiretroviral therapy in HIV-infected patients. |
| Publication Type | Journal Article |
| Year of Publication | 2006 |
| Authors | Freedberg, Kenneth A., Lisa R. Hirschhorn, Bruce R. Schackman, Lindsey L. Wolf, Lindsay A. Martin, Milton C. Weinstein, Susan Goldin, David A. Paltiel, Carol Katz, Sue J. Goldie, and Elena Losina |
| Journal | Journal of acquired immune deficiency syndromes (1999) |
| Volume | 43 Suppl 1 |
| Pagination | S113-8 |
| Date Published | 2006 Dec 1 |
| ISSN | 1525-4135 |
| 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 |
| 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. |
| DOI | 10.1111/j.1524-4733.2010.00763.x |
| Alternate Journal | J. Acquir. Immune Defic. Syndr. |
