The high cost of second-line antiretroviral therapy for HIV/AIDS in South Africa
The high cost of second-line antiretroviral therapy for HIV/AIDS in South Africa
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DOI：
10.1097/qad.0b013e3283360976
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发表时间：
2010-03-27
期刊：
影响因子：
3.8
通讯作者：
Rosen, Sydney
中科院分区：
文献类型：
--
作者：
Long, Lawrence;Fox, Matthew;Rosen, Sydney
目的：本文估计二线抗逆转录病毒治疗的成本和结果。二线药物的成本普遍高于一线药物，预计接受二线抗逆转录病毒治疗的患者绝对数量将随着时间的推移而增加。这些信息对于规划和预算至关重要。方法：为开始标准二线治疗的患者提取资源利用和结果数据。从二线治疗开始起 12 个月内测量资源使用情况，并在 12 个月时确定结果。使用标准成本计算技术将单位成本应用于资源使用。费用分为药物费用、实验室费用、就诊费用和固定费用。 12 个月时的结果是根据出勤状况、诊断结果和治疗状况确定的。报告了每名患者的平均费用和每项结果的平均费用。结果：在研究队列的 293 名参与者中，58% 仍在接受护理且有反应，15% 接受护理但没有反应，26% 不再接受护理。在二线治疗开始后的 12 个月内，每位参与者的平均费用为 1037 美元。每个患者的大部分费用归因于药物（71％），13％归因于实验室检查，10％归因于诊所和药房就诊，6％归因于基础设施和其他固定成本。二线治疗每年的护理费用是一线治疗的 2.4 倍。结论：随着治疗方案的成熟，二线治疗人数预计会逐渐增加，这可能会导致每位患者治疗的总体平均费用显着增加。 (C) 2010 年 Wolters Kluwer Health 垂直条 Lippincott Williams & Wilkins
Objective: The present article estimates the cost and outcomes of second-line anti-retroviral 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 anti-retroviral 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. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins