Cost and Cost-Effectiveness of Incentives for Viral Suppression in People Living with HIV
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...
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| Veröffentlicht in: | AIDS and behavior 2022-03, Vol.26 (3), p.795-804 |
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| creator | Dunlap, Laura J. Orme, Stephen Zarkin, Gary A. Holtgrave, David R. Maulsby, Catherine Rodewald, Andrew M. Holtyn, August F. Silverman, Kenneth |
| description | 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. |
| doi_str_mv | 10.1007/s10461-021-03439-x |
| format | Article |
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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. 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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. 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Academic</collection><jtitle>AIDS and behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dunlap, Laura J.</au><au>Orme, Stephen</au><au>Zarkin, Gary A.</au><au>Holtgrave, David R.</au><au>Maulsby, Catherine</au><au>Rodewald, Andrew M.</au><au>Holtyn, August F.</au><au>Silverman, Kenneth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost and Cost-Effectiveness of Incentives for Viral Suppression in People Living with HIV</atitle><jtitle>AIDS and behavior</jtitle><stitle>AIDS Behav</stitle><addtitle>AIDS Behav</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>26</volume><issue>3</issue><spage>795</spage><epage>804</epage><pages>795-804</pages><issn>1090-7165</issn><eissn>1573-3254</eissn><abstract>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. 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| subjects | Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Contingency Cost analysis Cost-Benefit Analysis Costs Drug use Health behavior Health care Health care expenditures Health Psychology Health services HIV HIV Infections - drug therapy Human immunodeficiency virus Humans Incentives Infectious Diseases Intervention Medicine Medicine & Public Health Motivation Original Paper Patient compliance Patients Public Health Quality-Adjusted Life Years United States Viral Load |
| title | Cost and Cost-Effectiveness of Incentives for Viral Suppression in People Living with HIV |
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