Limits...
Estimating the Impact and Cost of the WHO 2010 Recommendations for Antiretroviral Therapy.

Stover J, Bollinger L, Avila C - AIDS Res Treat (2010)

Bottom Line: In July 2010, WHO published new recommendations on providing antiretroviral therapy to adults and adolescents, including starting ART earlier, usually at a CD4 count of 350 or lower, specific regimens for first- and second-line therapies, and other recommendations.This paper estimates the potential impact and cost of the revised guidelines by first, calculating the number of people that would be in need of antiretroviral therapy (ART) with different eligibility criteria, and second, calculating the costs associated with the potential impact.When testing and outreach costs are included, total costs increase by 62%, from US$26.3 billion under the previous eligibility criterion of treating those with CD4 <200 to US$42.5 billion using the revised eligibility criterion of treating those with CD4 <350.

View Article: PubMed Central - PubMed

Affiliation: Futures Institute, 41-A New London Turnpike, Glastonbury, CT 06033, USA.

ABSTRACT
In July 2010, WHO published new recommendations on providing antiretroviral therapy to adults and adolescents, including starting ART earlier, usually at a CD4 count of 350 or lower, specific regimens for first- and second-line therapies, and other recommendations. This paper estimates the potential impact and cost of the revised guidelines by first, calculating the number of people that would be in need of antiretroviral therapy (ART) with different eligibility criteria, and second, calculating the costs associated with the potential impact. Results indicate that switching the eligibility criterion from CD4 count <200 to <350 increases the need for ART in low- and middle-income countries (country-level) by 50% (range 34% to 70%). The costs of ART programs only to increase coverage to 80% by 2015 would be 44% more (range 29% to 63%) when switching the eligibility criterion to CD4 count <350. When testing and outreach costs are included, total costs increase by 62%, from US$26.3 billion under the previous eligibility criterion of treating those with CD4 <200 to US$42.5 billion using the revised eligibility criterion of treating those with CD4 <350.

No MeSH data available.


Comparison of results for changing eligibility criterion to CD4 count <350 between LMIC and country-level calculations.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3066594&req=5

fig5: Comparison of results for changing eligibility criterion to CD4 count <350 between LMIC and country-level calculations.

Mentions: In order to compare results for different epidemic types and different regions, we performed the analysis for seven countries: Burkina Faso, Mexico, Nigeria, Russia, Tanzania, Ukraine, and Vietnam. Results indicate that there is not a great deal of variation across countries (see Figure 5). While the average percentage increase in the number of person-years on ART for LMIC was 50% when the eligibility criterion switched from CD4 count <200 to <350, this varies across countries from a low increase of 34% in Burkina Faso to a high increase of 70% in Vietnam. A similar pattern can be observed for AIDS deaths; the country level results range from a reduction of 16% in Burkina Faso to a reduction of 23% in Vietnam when the eligibility criterion switches to CD4 count <350. Finally, the changes in the country-level additional ART costs associated with changing the eligibility criterion mirror the changes in the results for LMIC; for LMIC, the additional ART costs increase by 44% when the eligibility criterion switches to CD4 count <350, while the increases at the country level vary from 30% (Burkina Faso) to 63% (Vietnam).


Estimating the Impact and Cost of the WHO 2010 Recommendations for Antiretroviral Therapy.

Stover J, Bollinger L, Avila C - AIDS Res Treat (2010)

Comparison of results for changing eligibility criterion to CD4 count <350 between LMIC and country-level calculations.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3066594&req=5

fig5: Comparison of results for changing eligibility criterion to CD4 count <350 between LMIC and country-level calculations.
Mentions: In order to compare results for different epidemic types and different regions, we performed the analysis for seven countries: Burkina Faso, Mexico, Nigeria, Russia, Tanzania, Ukraine, and Vietnam. Results indicate that there is not a great deal of variation across countries (see Figure 5). While the average percentage increase in the number of person-years on ART for LMIC was 50% when the eligibility criterion switched from CD4 count <200 to <350, this varies across countries from a low increase of 34% in Burkina Faso to a high increase of 70% in Vietnam. A similar pattern can be observed for AIDS deaths; the country level results range from a reduction of 16% in Burkina Faso to a reduction of 23% in Vietnam when the eligibility criterion switches to CD4 count <350. Finally, the changes in the country-level additional ART costs associated with changing the eligibility criterion mirror the changes in the results for LMIC; for LMIC, the additional ART costs increase by 44% when the eligibility criterion switches to CD4 count <350, while the increases at the country level vary from 30% (Burkina Faso) to 63% (Vietnam).

Bottom Line: In July 2010, WHO published new recommendations on providing antiretroviral therapy to adults and adolescents, including starting ART earlier, usually at a CD4 count of 350 or lower, specific regimens for first- and second-line therapies, and other recommendations.This paper estimates the potential impact and cost of the revised guidelines by first, calculating the number of people that would be in need of antiretroviral therapy (ART) with different eligibility criteria, and second, calculating the costs associated with the potential impact.When testing and outreach costs are included, total costs increase by 62%, from US$26.3 billion under the previous eligibility criterion of treating those with CD4 <200 to US$42.5 billion using the revised eligibility criterion of treating those with CD4 <350.

View Article: PubMed Central - PubMed

Affiliation: Futures Institute, 41-A New London Turnpike, Glastonbury, CT 06033, USA.

ABSTRACT
In July 2010, WHO published new recommendations on providing antiretroviral therapy to adults and adolescents, including starting ART earlier, usually at a CD4 count of 350 or lower, specific regimens for first- and second-line therapies, and other recommendations. This paper estimates the potential impact and cost of the revised guidelines by first, calculating the number of people that would be in need of antiretroviral therapy (ART) with different eligibility criteria, and second, calculating the costs associated with the potential impact. Results indicate that switching the eligibility criterion from CD4 count <200 to <350 increases the need for ART in low- and middle-income countries (country-level) by 50% (range 34% to 70%). The costs of ART programs only to increase coverage to 80% by 2015 would be 44% more (range 29% to 63%) when switching the eligibility criterion to CD4 count <350. When testing and outreach costs are included, total costs increase by 62%, from US$26.3 billion under the previous eligibility criterion of treating those with CD4 <200 to US$42.5 billion using the revised eligibility criterion of treating those with CD4 <350.

No MeSH data available.