NDLI: The high cost of second-line antiretroviral therapy for HIV/AIDS in South Africa.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Long, Lawrence Fox, Matthew Sanne, Ian Rosen, Sydney
Spatial Coverage	South Africa
Description	Country affiliation: South Africa Author Affiliation: Long L ( Health Economics and Epidemiology Research Office, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa. llong@heroza.org)
Abstract	OBJECTIVE: The present article estimates the cost and outcomes of second-line antiretroviral therapy. The cost of second-line drugs is generally higher than that of first-line drugs and it is expected that the absolute number of patients on second-line antiretroviral therapy will increase over time. This information is crucial for planning and budgeting. METHODS: Resource utilization and outcome data were extracted for patients who initiated standard second-line therapy. Resource usage was measured from second-line initiation for 12 months and outcomes were determined at 12 months. Unit costs were applied to resource usage using standard costing techniques. Costs were classified into drug, laboratory, visit, and fixed costs. Outcomes at 12 months were determined using attendance status, diagnostic results, and treatment status. Average cost per patient and average cost per outcome were reported. RESULTS: Of the 293 participants in the study cohort, 58% remained in care and responding, 15% were in care but not responding, and 26% were no longer in care. During the 12 months following second-line initiation, the average cost per participant was \$1037. Most of the cost per patient was attributable to drugs (71%), 13% to laboratory tests, 10% to clinic and pharmacy visits, and 6% to infrastructure and other fixed costs. Second-line therapy was 2.4 times more expensive per year in care than first-line therapy. CONCLUSION: The gradual increase in second-line numbers that can be expected as treatment programs mature may cause a meaningful increase in the overall average cost per patient treated.
File Format	HTM / HTML
ISSN	02699370
Issue Number	6
Volume Number	24
e-ISSN	14735571
Journal	AIDS
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-03-27
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Immunology Antiretroviral Therapy, Highly Active Economics Cd4 Lymphocyte Count Hiv Infections Hiv-1 Health Services Cost-benefit Analysis Drug Therapy Humans South Africa Epidemiology Journal Article Research Support, U.s. Gov't, Non-p.h.s.
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Immunology and Allergy Immunology

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Clinical impact and cost-effectiveness of antiretroviral therapy in India: starting criteria and second-line therapy.

Short-term and long-term risk of tuberculosis associated with CD4 cell recovery during antiretroviral therapy in South Africa.

Initiating patients on antiretroviral therapy at CD4 cell counts above 200 cells/microl is associated with improved treatment outcomes in South Africa.

CD4 count slope and mortality in HIV-infected patients on antiretroviral therapy: multicohort analysis from South Africa.

Virologic failure and second-line antiretroviral therapy in children in South Africa--the IeDEA Southern Africa collaboration.

Providing immediate CD4 count results at HIV testing improves ART initiation.

Persistence of HIV-associated cognitive impairment, inflammation, and neuronal injury in era of highly active antiretroviral treatment.

Central nervous system disorders after starting antiretroviral therapy in South Africa.

Cost-effectiveness of antiretroviral regimens in the World Health Organization's treatment guidelines: a South African analysis.

The high cost of second-line antiretroviral therapy for HIV/AIDS in South Africa.

Similar Documents

Clinical impact and cost-effectiveness of antiretroviral therapy in India: starting criteria and second-line therapy.

Short-term and long-term risk of tuberculosis associated with CD4 cell recovery during antiretroviral therapy in South Africa.

Initiating patients on antiretroviral therapy at CD4 cell counts above 200 cells/microl is associated with improved treatment outcomes in South Africa.

CD4 count slope and mortality in HIV-infected patients on antiretroviral therapy: multicohort analysis from South Africa.

Virologic failure and second-line antiretroviral therapy in children in South Africa--the IeDEA Southern Africa collaboration.

Providing immediate CD4 count results at HIV testing improves ART initiation.

Persistence of HIV-associated cognitive impairment, inflammation, and neuronal injury in era of highly active antiretroviral treatment.

Central nervous system disorders after starting antiretroviral therapy in South Africa.

Cost-effectiveness of antiretroviral regimens in the World Health Organization's treatment guidelines: a South African analysis.

The high cost of second-line antiretroviral therapy for HIV/AIDS in South Africa.