Costs and Cost-Effectiveness of the Patient-Centered HIV Care Model: A Collaboration Between Community-Based Pharmacists and Primary Medical Providers.

Autor:	Shrestha RK; Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Schommer JC; Department of Pharmaceutical Care & Health Systems, University of Minnesota, College of Pharmacy, Minneapolis, MN., Taitel MS; Health Analytics, Research, and Reporting, Walgreen Co., Deerfield, IL., Garza OW; Department of Pharmaceutical Care & Health Systems, University of Minnesota, College of Pharmacy, Minneapolis, MN.; Currently, School of Clinical Sciences, College of Pharmacy, University of Louisiana Monroe, Monroe, LA., Camp NM; Department of Health, Research, Informatics, and Technology, ICF, Atlanta, GA., Akinbosoye OE; Pharmacy Analytics and Global Insights, Walgreen Co., Deerfield, IL.; Currently, Astellas Pharma, Tokyo, Japan; and., Clay PG; Department of Pharmacotherapy, University of North Texas Health Science Center System College of Pharmacy, Fort Worth, TX., Byrd KK; Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2020 Nov 01; Vol. 85 (3), pp. e48-e54.
DOI:	10.1097/QAI.0000000000002458
Abstrakt:	Background: The patient-centered HIV care model (PCHCM) is an evidence-informed structural intervention that integrates community-based pharmacists with primary medical providers to improve rates of HIV viral suppression. This report assesses the costs and cost-effectiveness of the PCHCM. Setting: Patient-centered HIV care model. Methods: Three project sites, each composed of a medical clinic and 1 or 2 community-based HIV-specialized pharmacies, were included in the analyses. PCHCM required patient data sharing between medical providers and pharmacists and collaborative therapy-related decision making. Intervention effectiveness was measured as the incremental number of patients virally suppressed (HIV RNA <200 copies/mL at the last test in a 12-month measurement period). Microcosting direct measurement methods were used to estimate intervention costs. The cost per patient, cost per patient visit, and incremental cost per patient virally suppressed were calculated from the health care providers' perspective. Additionally, the number of HIV transmissions averted, lifetime HIV treatment cost saved, quality-adjusted life years (QALYs) saved, and cost per QALY saved were calculated from the societal perspective, using standard methods and reported values from the published literature. Results: Overall, the PCHCM annual intervention cost for the 3 project sites was $226,741. The average cost per patient, cost per patient visit, and incremental cost per patient virally suppressed were $813, $48, and $5,039, respectively. The intervention averted 2.75 HIV transmissions and saved 12.22 QALYs and nearly $1.28 million in lifetime HIV treatment costs. The intervention was cost saving overall and at each project site. Conclusions: The PCHCM can be delivered at a relatively low cost and is a cost-saving intervention to assist patients in achieving viral suppression and preventing HIV transmission.
Databáze:	MEDLINE
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