Estimating the cost and efficiency gain of rolling out a multi-month dispensing programme for antiretroviral treatment in Tanzania.

IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Ajar-African Journal of Aids Research Pub Date : 2022-12-01 DOI:10.2989/16085906.2022.2133619
George Ruhago, Steven Forsythe, Roland Van de Ven, Louis Apicella
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Abstract

Background: Globally, efforts to curtail the HIV pandemic are growing. The Joint United Nations Programme on HIV and AIDS (UNAIDS) and partners set the 95-95-95 targets to be achieved by 2025. Tanzania's ongoing transition from single-month ARV to longer multi-month dispensing (MMD) involves significant planning and shifts in existing resources, including health commodities, clinical staff and storage space. This study aimed at evaluating the costs and efficiency gains of rolling out MMD compared to the prior monthly dispending (MD) standard of care before the new guidelines.Methods: The analysis employed a health provider perspective utilising prior costing data collected to estimate cost of treatment for HIV/AIDS, including salaries, laboratory costs, antiretroviral drugs, other supplies and overhead costs. The projections were run from 2018 to 2030 using the Spectrum package for Tanzania.Results: Our model estimated that total treatment cost without MMD (including salaries, laboratory costs, antiretroviral drugs, other supplies, and overhead costs) is estimated to rise from USD 189 million in 2018 to USD 244 million in 2030. The introduction of a six-month MMD would lead to the total annual facility-based treatment costs being reduced to USD 205 million in 2030. When comparing MD to a six-month MMD, the total savings over the 13-year period would be USD 425 million. The introduction of six-month MMD for stable patients would reduce the average cost from USD 180 to USD 156 per patient per year if stable patients were only required to make six-monthly visit.Conclusions: The introduction of differentiated service delivery models (DSDMs) and MMD is already contributing to significant cost savings for Tanzania and will continue to do so as the country puts more stable patients on MMD. The potential gains from MMD implantation could further be harnessed if retention of treatment and viral suppression monitoring are prioritised.

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估计在坦桑尼亚推出为期数月的抗逆转录病毒治疗配药规划的成本和效率增益。
背景:在全球范围内,遏制艾滋病毒流行的努力正在加强。联合国艾滋病规划署(UNAIDS)及其合作伙伴制定了到2025年要实现的“95-95-95”目标。坦桑尼亚正在进行的从单月抗逆转录病毒药物分配向更长时间的多月配药的过渡涉及重大规划和现有资源的转移,包括保健商品、临床工作人员和储存空间。本研究旨在评估与新指南出台之前的每月分配(MD)护理标准相比,推出MMD的成本和效率收益。方法:分析采用了保健提供者的观点,利用先前收集的成本核算数据来估计艾滋病毒/艾滋病治疗费用,包括工资、化验室费用、抗逆转录病毒药物、其他用品和间接费用。这些预测是在2018年至2030年期间使用坦桑尼亚的Spectrum一揽子计划进行的。结果:我们的模型估计,无烟雾病的总治疗费用(包括工资、实验室费用、抗逆转录病毒药物、其他用品和间接费用)估计将从2018年的1.89亿美元上升到2030年的2.44亿美元。到2030年,引入为期6个月的MMD将使基于设施的年度总处理成本降至2.05亿美元。当将MD与6个月的MMD进行比较时,13年期间的总节省将达到4.25亿美元。如果病情稳定的患者只需要进行6个月的就诊,那么对病情稳定的患者进行6个月的MMD治疗将使每位患者每年的平均费用从180美元降至156美元。结论:差异化服务交付模式(DSDMs)和烟雾疗法的引入已经为坦桑尼亚节省了大量的成本,并且随着该国让更多稳定的患者接受烟雾疗法,这种情况将继续下去。如果优先考虑保留治疗和病毒抑制监测,则可以进一步利用烟雾剂植入的潜在收益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ajar-African Journal of Aids Research
Ajar-African Journal of Aids Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
1.80
自引率
8.30%
发文量
38
审稿时长
>12 weeks
期刊介绍: African Journal of AIDS Research (AJAR) is a peer-reviewed research journal publishing papers that make an original contribution to the understanding of social dimensions of HIV/AIDS in African contexts. AJAR includes articles from, amongst others, the disciplines of sociology, demography, epidemiology, social geography, economics, psychology, anthropology, philosophy, health communication, media, cultural studies, public health, education, nursing science and social work. Papers relating to impact, care, prevention and social planning, as well as articles covering social theory and the history and politics of HIV/AIDS, will be considered for publication.
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