Cost and Cost-Effectiveness of Incentives for Viral Suppression in People Living with HIV
| Autor: | Laura J. Dunlap, August F. Holtyn, Stephen Orme, Cathy Maulsby, David R. Holtgrave, Gary A. Zarkin, Kenneth Silverman, Andrew M. Rodewald |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Social Psychology Cost effectiveness business.industry Public health Public Health Environmental and Occupational Health Contingency management Health psychology Infectious Diseases Incentive Intervention (counseling) Environmental health Health care medicine business Viral load health care economics and organizations |
| Zdroj: | AIDS and Behavior. 26:795-804 |
| ISSN: | 1573-3254 1090-7165 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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