Cost and Cost-Effectiveness of Incentives for Viral Suppression in People Living with HIV.

Autor: Dunlap LJ; Behavioral Health Research Division, RTI International, Research Triangle Park, NC, USA., Orme S; Behavioral Health Research Division, RTI International, Research Triangle Park, NC, USA. sorme@rti.org.; RTI International, 701 13th Street NW, Suite 750, Washington, DC, 20005-3967, USA. sorme@rti.org., Zarkin GA; Behavioral Health Research Division, RTI International, Research Triangle Park, NC, USA., Holtgrave DR; School of Public Health, and Center for Collaborative HIV Research in Practice and Policy, State University of New York, Albany, NY, USA., Maulsby C; Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Rodewald AM; Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Holtyn AF; Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Silverman K; Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2022 Mar; Vol. 26 (3), pp. 795-804. Date of Electronic Publication: 2021 Aug 26.
DOI: 10.1007/s10461-021-03439-x
Abstrakt: Only 63% of people living with HIV in the United States are achieving viral suppression. Structural and social barriers limit adherence to antiretroviral therapy which furthers the HIV epidemic while increasing health care costs. This study calculated the cost and cost-effectiveness of a contingency management intervention with cash incentives. People with HIV and detectable viral loads were randomized to usual care or an incentive group. Individuals could earn up to $3650 per year if they achieved and maintained an undetectable viral load. The average 1-year intervention cost, including incentives, was $4105 per patient. The average health care costs were $27,189 per patient in usual care and $35,853 per patient in the incentive group. We estimated a cost of $28,888 per quality-adjusted life-year (QALY) gained, which is well below accepted cost-per-QALY thresholds. Contingency management with cash incentives is a cost-effective intervention for significantly increasing viral suppression.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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