The cost of HIV medication adherence support interventions

Results of a cross-site evaluation

Bibliographic Data

ID19441195
AuthorsBruce R Schackman (0000-0002-1132-2932, Cornell University, corresponding author), Ruth Finkelstein (0000-0001-7702-3778, New York Academy of Medicine), Christopher P Neukermans (Cornell University), Lara Lewis (0000-0001-5373-2086, New York Academy of Sciences), Lois Eldred (0000-0003-1908-7321, Health Resources and Services Administration), CENTER FOR ADHERENCE SUPPORT AND EV CENTER FOR ADHERENCE SUPPORT AND EV, CENTER FOR ADHERENCE SUPPORT AND EV
Year2005
Volume17
Issue8
Pages927-937
Publication date2005-11-01
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540120500100635
PMID16265786
OpenAlexW1998107797
LanguageEN
Citations received3
References cited26

The objective of this study was to determine the direct cost of HIV adherence support programmes participating in a cross-site evaluation in the US. Data on the frequency, type, and setting of adherence encounters; providers' professions; and adherence tools provided were collected for 1,122 patients enrolled in 13 interventions at 9 sites. The site staff estimated the average duration of each type of encounter and national wage rates were used for labour costs. The median (range) adherence encounters/year among interventions was 16.5 (4.3-104.6) per patient; encounters lasted 24.6 (8.9-40.9) minutes. Intervention direct cost was correlated with the average frequency of encounters (r = 0.57), but not with encounter duration or providers' professions. The median direct cost/month was 35 dollars(5 dollars-58 dollars) per patient, and included direct provider costs (66%); incentives (17%); reminders and other tools (8%); and direct administrative time, provider transportation, training, and home delivery (9%). The median direct cost/month from a societal perspective, which includes patient time and travel costs, was 47 dollars(24 dollars-114 dollars) per patient. Adherence interventions with moderate efficacy costing < or =100 dollars/month have been estimated to meet a cost-effectiveness threshold that is generally accepted in the US. Payers should consider enhanced reimbursement for adherence support services

Environmental health · Family medicine · Medication adherence · Psychological intervention · HIV-related health complications and treatments · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions · Medicine · Nursing · Internal Medicine

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