HIV Treatment as Prevention: Modelling the Cost of Antiretroviral Treatment—State of the Art and Future Directions
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{"title"=>"HIV treatment as prevention: Modelling the cost of antiretroviral treatment-state of the art and future directions", "type"=>"generic", "authors"=>[{"first_name"=>"Gesine", "last_name"=>"Meyer-Rath", "scopus_author_id"=>"21934957800"}, {"first_name"=>"Mead", "last_name"=>"Over", "scopus_author_id"=>"6603049278"}], "year"=>2012, "source"=>"PLoS Medicine", "identifiers"=>{"scopus"=>"2-s2.0-84864493215", "isbn"=>"1549-1277", "doi"=>"10.1371/journal.pmed.1001247", "pui"=>"365352074", "sgr"=>"84864493215", "issn"=>"15491277", "pmid"=>"22802731"}, "id"=>"b36594c5-6f35-396e-80d9-bb570c377294", "abstract"=>"Policy discussions about the feasibility of massively scaling up antiretroviral therapy (ART) to reduce HIV transmission and incidence hinge on accurately projecting the cost of such scale-up in comparison to the benefits from reduced HIV incidence and mortality. We review the available literature on modelled estimates of the cost of providing ART to different populations around the world, and suggest alternative methods of characterising cost when modelling several decades into the future. In past economic analyses of ART provision, costs were often assumed to vary by disease stage and treatment regimen, but for treatment as prevention, in particular, most analyses assume a uniform cost per patient. This approach disregards variables that can affect unit cost, such as differences in factor prices (i.e., the prices of supplies and services) and the scale and scope of operations (i.e., the sizes and types of facilities providing ART). We discuss several of these variables, and then present a worked example of a flexible cost function used to determine the effect of scale on the cost of a proposed scale-up of treatment as prevention in South Africa. Adjusting previously estimated costs of universal testing and treatment in South Africa for diseconomies of small scale, i.e., more patients being treated in smaller facilities, adds 42% to the expected future cost of the intervention.", "link"=>"http://www.mendeley.com/research/hiv-treatment-prevention-modelling-cost-antiretroviral-treatmentstate-art-future-directions", "reader_count"=>105, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>9, "Researcher"=>25, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>18, "Student > Postgraduate"=>9, "Student > Master"=>21, "Other"=>3, "Student > Bachelor"=>4, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>3, "Professor"=>4}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>9, "Researcher"=>25, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>18, "Student > Postgraduate"=>9, "Student > Master"=>21, "Other"=>3, "Student > Bachelor"=>4, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>3, "Professor"=>4}, "reader_count_by_subject_area"=>{"Unspecified"=>10, "Nursing and Health Professions"=>2, "Mathematics"=>4, "Medicine and Dentistry"=>37, "Agricultural and Biological Sciences"=>7, "Arts and Humanities"=>2, "Business, Management and Accounting"=>6, "Psychology"=>1, "Social Sciences"=>18, "Immunology and Microbiology"=>3, "Economics, Econometrics and Finance"=>15}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>37}, "Social Sciences"=>{"Social Sciences"=>18}, "Psychology"=>{"Psychology"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>3}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>15}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>7}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>6}, "Mathematics"=>{"Mathematics"=>4}, "Unspecified"=>{"Unspecified"=>10}, "Arts and Humanities"=>{"Arts and Humanities"=>2}}, "reader_count_by_country"=>{"United States"=>4, "South Africa"=>3, "Nigeria"=>1, "Portugal"=>1}, "group_count"=>11}

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/611002"], "description"=>"<p>Based on <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001247#pmed.1001247-Rosen1\" target=\"_blank\">[78]</a>. *, difference from public hospital significant at <i>p</i><0.05. GPs, general practitioners; PHC, primary health care clinic; USD, US dollars.</p>", "links"=>[], "tags"=>["settings"], "article_id"=>281497, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gesine Meyer-Rath", "Mead Over"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001247.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Annual_per_patient_cost_of_ART_provision_in_four_different_settings_in_South_Africa_/281497", "title"=>"Annual per patient cost of ART provision in four different settings in South Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-07-10 00:24:57"}
  • {"files"=>["https://ndownloader.figshare.com/files/611062"], "description"=>"<p>Based on <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001247#pmed.1001247-Rosen1\" target=\"_blank\">[78]</a>. GPs, general practitioners; PHC, primary health care clinic; USD, US dollars.</p>", "links"=>[], "tags"=>["settings"], "article_id"=>281556, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gesine Meyer-Rath", "Mead Over"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001247.g002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Annual_per_patient_cost_of_ART_provision_per_type_of_outcome_in_four_different_settings_in_South_Africa_/281556", "title"=>"Annual per patient cost of ART provision per type of outcome in four different settings in South Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-07-10 00:25:56"}
  • {"files"=>["https://ndownloader.figshare.com/files/611116"], "description"=>"<p>Size-rank distribution of ART facilities in 2010 and projected to future years in order to implement a universal test-and-treat strategy in South Africa.</p>", "links"=>[], "tags"=>["facilities", "2010", "projected", "years", "test-and-treat"], "article_id"=>281611, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gesine Meyer-Rath", "Mead Over"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001247.g003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Size_rank_distribution_of_ART_facilities_in_2010_and_projected_to_future_years_in_order_to_implement_a_universal_test_and_treat_strategy_in_South_Africa_/281611", "title"=>"Size-rank distribution of ART facilities in 2010 and projected to future years in order to implement a universal test-and-treat strategy in South Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-07-10 00:26:51"}
  • {"files"=>["https://ndownloader.figshare.com/files/611191"], "description"=>"<p>UTT, universal testing and treatment.</p>", "links"=>[], "tags"=>["elasticity", "test-and-treat"], "article_id"=>281688, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gesine Meyer-Rath", "Mead Over"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001247.g004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Impact_of_scale_elasticity_on_future_cost_of_a_universal_test_and_treat_strategy_in_South_Africa_/281688", "title"=>"Impact of scale elasticity on future cost of a universal test-and-treat strategy in South Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-07-10 00:28:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/611234"], "description"=>"<p>Schematic summary of determinants of the cost of ART provision.</p>", "links"=>[], "tags"=>["determinants"], "article_id"=>281734, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gesine Meyer-Rath", "Mead Over"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001247.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Schematic_summary_of_determinants_of_the_cost_of_ART_provision_/281734", "title"=>"Schematic summary of determinants of the cost of ART provision.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-10 00:28:54"}
  • {"files"=>["https://ndownloader.figshare.com/files/611258"], "description"=>"a<p>One publication (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001247#pmed.1001247-Risebrough1\" target=\"_blank\">[28]</a>; in abstract format) has no information on whether sensitivity analysis was conducted.</p>b<p>For zidovudine monotherapy.</p>c<p>For dual therapy.</p>d<p>For highly active ART.</p>e<p>One study <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001247#pmed.1001247-Kumaranayake1\" target=\"_blank\">[50]</a> does not supply enough information on ART input cost to know whether it is constant.</p>f<p>Analysis from 2011, based on country-level cost data.</p>g<p>Analysis from 1997, based on high-income country cost data extrapolated worldwide.</p><p>CHAI, Clinton HIV/AIDS Initiative; GNP, gross national product; QALY, quality-adjusted life year.</p>", "links"=>[], "tags"=>["methods", "published", "modelled", "analyses", "antiretroviral"], "article_id"=>281753, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gesine Meyer-Rath", "Mead Over"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001247.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Overview_of_the_methods_and_results_of_previously_published_modelled_economic_analyses_of_antiretroviral_treatment_/281753", "title"=>"Overview of the methods and results of previously published modelled economic analyses of antiretroviral treatment.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-10 00:29:13"}

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Relative Metric

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