How to Estimate the Cost of Point-of-Care CD4 Testing in Program Settings: An Example Using the Alere Pima™ Analyzer in South Africa
How to Estimate the Cost of Point-of-Care CD4 Testing in Program Settings: An Example Using the Alere Pima™ Analyzer in South Africa
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DOI：
10.1371/journal.pone.0035444
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发表时间：
2012-04-20
期刊：
影响因子：
3.7
通讯作者：
Rosen, Sydney
中科院分区：
文献类型：
--
作者：
Larson, Bruce;Schnippel, Kathryn;Rosen, Sydney
将POC CD4检测技术整合到艾滋病毒咨询和检测(HCT)计划中，可能会改善艾滋病毒后检测与护理和治疗的联系。随着在计划设置中对这些技术的评估继续进行，将需要对服务提供商的POC CD4测试的成本进行估计，并且已经开始报告估计值。如果没有一致和透明的方法，使用POC技术对每项CD4检测成本的估计可能很难进行比较，并可能导致关于成本和成本效益的错误结论。本文提供了一种循序渐进的方法，从供应商的角度估计每项CD4测试的成本。作为例子，该方法被应用于一种特定的PoC技术，即PIMA(TM)分析器。成本计算方法以南非豪登省流动HCT项目的数据为例进行了说明。对于这个项目，2010年的每次测试成本估计为23.76美元(材料成本=8.70美元；每次测试的劳动力成本=7.33美元；以及设备、保险和日常质量控制=7.72美元)。劳动力和设备成本可能会有很大的差异，这取决于该计划的运作方式以及随着时间的推移完成的CD4测试的数量。上述分析中没有包括的持续培训、监督和质量控制的额外成本可能会进一步增加每次测试的成本。本文的主要贡献是概述了一种估计将POC CD4测试技术纳入HCT计划的成本的方法。计划设置的细节对成本估算有重要影响，因此这些细节应该被清楚地记录下来，以提高成本估算的一致性、透明度和可比性。
Integrating POC CD4 testing technologies into HIV counseling and testing (HCT) programs may improve post-HIV testing linkage to care and treatment. As evaluations of these technologies in program settings continue, estimates of the costs of POC CD4 tests to the service provider will be needed and estimates have begun to be reported. Without a consistent and transparent methodology, estimates of the cost per CD4 test using POC technologies are likely to be difficult to compare and may lead to erroneous conclusions about costs and cost-effectiveness. This paper provides a step-by-step approach for estimating the cost per CD4 test from a provider's perspective. As an example, the approach is applied to one specific POC technology, the Pima (TM) Analyzer. The costing approach is illustrated with data from a mobile HCT program in Gauteng Province of South Africa. For this program, the cost per test in 2010 was estimated at $23.76 (material costs = $8.70; labor cost per test = $7.33; and equipment, insurance, and daily quality control = $7.72). Labor and equipment costs can vary widely depending on how the program operates and the number of CD4 tests completed over time. Additional costs not included in the above analysis, for on-going training, supervision, and quality control, are likely to increase further the cost per test. The main contribution of this paper is to outline a methodology for estimating the costs of incorporating POC CD4 testing technologies into an HCT program. The details of the program setting matter significantly for the cost estimate, so that such details should be clearly documented to improve the consistency, transparency, and comparability of cost estimates.