Cost of behavioral interventions utilizing electronic drug monitoring for antiretroviral therapy adherence.
Cost of behavioral interventions utilizing electronic drug monitoring for antiretroviral therapy adherence.
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DOI：
10.1097/qai.0b013e318285d951
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发表时间：
2013-05-01
期刊：
影响因子：
--
通讯作者：
Goggin K
中科院分区：
文献类型：
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作者：
Rasu RS;Malewski DF;Banderas JW;Malomo Thomson D;Goggin K
提供与临床试验中使用的行为艺术依从性干预和电子药物监测相关的实际成本的数据，以告知它们在未来研究和现实世界实践中的实施情况。直接成本和时间成本是从一项多点三臂随机对照ART依从性试验中计算出来的。HIV阳性参与者(n=204)被随机分为标准护理(SC)、强化咨询(EC)或EC和改良直接观察疗法(MDOT)干预。采用电子药物监测(EDM)。计算了24周依从性干预的各个组成部分的成本。这项经济评价是从一个可能希望执行这些战略的机构的角度进行的。进行了敏感性分析，以检查与不同方案相关的费用和节省。总直接成本为126,068美元(每名患者618美元)。初始时间成本为53,590美元(每个患者262美元)。基本人工成本为0.36美元/分钟。134名患者的EC成本为18,427美元(每名患者137美元)，患者的MDOT成本为18,638美元(每名患者291美元)。每个患者的总成本为：SC=880美元，EC=1,018美元，EC/MDOT=1,309美元。剔除驾驶成本对三个研究部门之间的节省的影响最不稳定。龙卷风图(敏感度分析)图示了每个敏感度假设如何彼此相比如何降低费用，以及由此产生的每一组的比较费用。这种新颖的经济分析为指导治疗实施和研究设计决策提供了有价值的成本信息。
To provide data on the actual costs associated with behavioral ART adherence interventions and electronic drug monitoring used in a clinical trial to inform their implementation in future studies and real-world practice. Direct and time costs were calculated from a multi-site three-arm randomized controlled ART adherence trial. HIV positive participants (n = 204) were randomized to standard care (SC), enhanced counseling (EC), or EC and modified directly observed therapy (mDOT) interventions. Electronic drug monitoring (EDM) was used. Costs were calculated for various components of the 24-week adherence intervention. This economic evaluation was conducted from the perspective of an agency that may wish to implement these strategies. Sensitivity analyses were conducted to examine costs and savings associated with different scenarios. Total direct costs were $126,068 ($618/patient). Initial time costs were $53,590 ($262/patient). Base cost of labor was $0.36/minute. EC costs for 134 patients were $18,427 ($137/patient) and mDOT for 64 patients cost $18,638 ($291/patient). Total per patient costs were: SC=$880, EC=$1,018, EC/mDOT=$1,309. Removing driving costs evidenced the most variable impact on savings between the three study arms. The tornado diagram (sensitivity analysis) showed a graphical representation of how each sensitivity assumption reduced costs compared to each other and the resulting comparative costs for each group. This novel economic analysis provides valuable cost information to guide treatment implementation and research design decisions.