scholarly journals Evaluating the cost-effectiveness of TB diagnostic strategies in HIV-positive patients in Lusaka, Zambia

2012 ◽  
Vol 16 ◽  
pp. e286 ◽  
Author(s):  
L. Mishra ◽  
G. Henostroza ◽  
J. Harris ◽  
M. Siyambango ◽  
A. Krunner ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hiv Positive ◽  
Diagnostic Strategies ◽  
The Cost

scholarly journals Cost-effectiveness of facility-based, stand-alone and mobile-based voluntary counseling and testing for HIV in Addis Ababa, Ethiopia

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Amanuel Yigezu ◽  
Senait Alemayehu ◽  
Shallo Daba Hamusse ◽  
Getachew Teshome Ergeta ◽  
Damen Hailemariam ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Addis Ababa ◽  
Unit Cost ◽  
Hiv Positive ◽  
Testing Methods ◽  
Voluntary Counseling ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
The Cost ◽  
Hiv Seropositive

Abstract Background Globally, there is a consensus to end the HIV/AIDS epidemic by 2030, and one of the strategies to achieve this target is that 90% of people living with HIV should know their HIV status. Even if there is strong evidence of clients’ preference for testing in the community, HIV voluntary counseling and testing (VCT) continue to be undertaken predominantly in health facilities. Hence, empirical cost-effectiveness evidence about different HIV counseling and testing models is essential to inform whether such community-based testing are justifiable compared with additional resources required. Therefore, the purpose of this study was to compare the cost-effectiveness of facility-based, stand-alone and mobile-based HIV voluntary counseling and testing methods in Addis Ababa, Ethiopia. Methods Annual economic costs of counseling and testing methods were collected from the providers’ perspective from July 2016 to June 2017. Ingredients based bottom-up costing approach was applied. The effectiveness of the interventions was measured in terms of the number of HIV seropositive clients identified. Decision tree modeling was built using TreeAge Pro 2018 software, and one-way and probabilistic sensitivity analyses were conducted by varying HIV positivity rate, costs, and probabilities. Results The cost of test per client for facility-based, stand-alone and mobile-based VCT was $5.06, $6.55 and $3.35, respectively. The unit costs of test per HIV seropositive client for the corresponding models were $158.82, $150.97 and $135.82, respectively. Of the three models, stand-alone-based VCT was extendedly dominated. Mobile-based VCT costs, an additional cost of USD 239 for every HIV positive client identified when compared to facility-based VCT. Conclusion Using a mobile-based VCT approach costs less than both the facility-based and stand-alone approaches, in terms of both unit cost per tested individual and unit cost per HIV seropositive cases identified. The stand-alone VCT approach was not cost-effective compared to facility-based and mobile-based VCT. The incremental cost-effectiveness ratio for mobile-based VCT compared with facility-based VCT was USD 239 per HIV positive case.

scholarly journals Management of End Stage Renal Disease in Persons Living with HIV: A Cost-Effectiveness Analysis

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S436-S436
Author(s):  
Winston B Joe ◽  
Ellen F Eaton
Keyword(s):  
Cost Effectiveness ◽  
Acute Rejection ◽  
Cost Effective ◽  
Small Sample ◽  
Sensitivity Analyses ◽  
Hiv Positive ◽  
Persons Living With Hiv ◽  
The Cost ◽  
Living With Hiv ◽  
Rejection Rates

Abstract Background HIV+ kidney transplant (KT) for persons living with HIV (PLWH) is both safe and effective, with comparable patient and graft survival rates relative to HIV- KT. The objective of this study was to evaluate the cost-effectiveness of HIV+ KT relative to HIV- KT and dialysis. Methods A decision-tree framework was used to assess the cost-effectiveness of the above treatment options for PLWH. Clinical outcomes at 3 years for KT and effectiveness data (expressed in QALYs) were abstracted from previous publications, when available. Costs were assigned from a payer’s perspective using the US Renal Data System and published literature (expressed in 2014 USD). This analysis assumed a three-year time horizon. Sensitivity analyses were explored to understand how changes in 1) acute KT rejection and 2) KT failure impact cost effectiveness. Limitations include small sample size and short follow up time in referenced studies and a lack of health utility data in HIV positive persons with renal failure. We used TreeAge Software (Williamstown, MA). Results HIV+ KT was most cost effective ($299,904/QALY) while both HIV- KT ($329,676) and dialysis ($444,645) were dominated, meaning more costly and less effective. Results were sensitive to the higher KT failure (26% vs. 16%) and acute rejection (39% vs. 17%) observed with HIV- KT relative to HIV+ KT. In sensitivity analysis, as HIV+ KT rejection rates approach 20%, HIV- KT becomes a cost-effective option. As HIV+ KT failure rates approach 26%, HIV- KT becomes cost effective. Conclusion Despite its limitations, this analysis demonstrates that HIV+ kidney transplantation is a cost-effective alternative for PLWH under certain conditions. As KT outcomes, like graft failure and acute rejection rates, continue to improve, it is likely that both HIV positive and negative KT will be cost-effective alternatives to dialysis. Disclosures All authors: No reported disclosures.

The cost-effectiveness of diagnostic strategies in patients with suspected pulmonary embolism

1996 ◽  
Vol 5 (4) ◽  
pp. 307-318 ◽  
Author(s):  
Bowine C. Michel ◽  
Rob J. Seerden ◽  
Frans F. H. Rutten ◽  
Edwin J. R. van Beek ◽  
Harry R. Büller
Keyword(s):  
Pulmonary Embolism ◽  
Cost Effectiveness ◽  
Suspected Pulmonary Embolism ◽  
Diagnostic Strategies ◽  
The Cost

scholarly journals Cost Effectiveness Analysis of Azithromycin and Doxycycline forChlamydia TrachomatisInfection in Women: A Canadian Perspective

1997 ◽  
Vol 8 (4) ◽  
pp. 202-208 ◽  
Author(s):  
Fawziah Marra ◽  
Carlo A Marra ◽  
David M Patrick
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Hypothetical Cohort ◽  
Chlamydia Infection ◽  
Economic Evaluations ◽  
Base Case ◽  
Diagnostic Strategies ◽  
The Cost

OBJECTIVE: To assess the cost effectiveness of azithromycin versus doxycycline therapy for cervicalChlamydia trachomatisinfections in Canada.DESIGN: A predictive decision analytic model using previously published clinical and economic evaluations, expert opinion and costs of medical care in Canada.POPULATION: A hypothetical cohort of 5000 women followed over 10 years.INTERVENTIONS: Two diagnostic strategies were compared, laboratory confirmed diagnosis (LCD) and presumptive diagnosis (PD) ofC trachomatisinfection. Under each strategy, two treatment alternatives were analyzed, a single 1 g dose of azithromycin and a seven-day course of doxycycline as 100 mg twice daily.RESULTS: Despite a fourfold higher acquisition cost, under base case conditions, for both diagnostic strategies, the azithromycin treatment alternative was more cost effective than the doxycycline alternative. For the LCD model, the cost per cure for patients receiving azithromycin was $184.76 compared with $240.59 for patients receiving doxycycline, resulting in an incremental cost of $55.83. For the PD model, the cost per cure for patients treated with azithromycin was $51.48 compared with $51.82, resulting in an incremental cost of $0.34. For the hypothetical cohort of 5000 women, the use of azithromycin translates into a projected annual cost savings of $279,150 and $1,700 for the LCD and PD models, respectively. In one-way sensitivity analyses for the LCD model, no clinically plausible changes in the base case estimates changed the results of the cost effectiveness outcome. In the PD model, clinically plausible changes in the probabilities of doxycycline cure, pelvic inflammatory disease, sequelae and chlamydia infection were found to alter the cost effectiveness outcome.CONCLUSIONS: Based on the results from our model, the azithromycin strategy should be employed for the treatment of laboratory confirmed cases. However, for presumptive cases, azithromycin should be used only if the probabilities ofC trachomatisand pelvic inflammatory disease are more than 19%, doxycycline effectiveness is less than 78%, or the cost of azithromycin is less than $19.00.

scholarly journals The optimal diagnostic strategies for patient with coronary artery diseases and stable chest pain syndrome: a cost-effectiveness analysis

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Parvin Jafari ◽  
Reza Goudarzi ◽  
Mohammadreza Amiresmaeili ◽  
Hamidreza Rashidinejad
Keyword(s):  
Computed Tomography ◽  
Cost Effectiveness ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Correct Diagnosis ◽  
Cost Effective ◽  
Diagnostic Strategies ◽  
Effectiveness Analysis ◽  
Artery Disease ◽  
The Cost

Abstract Background Numerous invasive and noninvasive diagnostic tests with different cost and effectiveness exist for detection of coronary artery disease. This diversity leads to unnecessary utilization of health services. For this reason, this study focused on the cost-effectiveness analysis of diagnostic strategies for coronary artery disease from the perspective of the health care system with 1-year time horizon. Results Incremental cost effectiveness ratios of all strategies were less than the threshold except for the electrocardiography-computed tomography angiography-coronary angiography strategy, and cost of the cardiac magnetic resonance imaging-based strategy was higher than the cost of other strategies. Also, the number of correct diagnosis in the electrocardiography-coronary angiography strategy was higher than the other strategies, and its ICER was 15.197 dollars per additional correct diagnosis. Moreover, the sensitivity analysis found that the probability of doing MRI and sensitivity of the exercise electrocardiography had impact on the results. Conclusion The most cost-effective strategy for acute patient is ECG-CA strategy, and for chronic patient, the most cost-effective strategies are electrocardiography-single photon emission computed tomography-coronary angiography and electrocardiography-exercise electrocardiography-coronary angiography. Applying these strategies in the same clinical settings may lead to a better utilization of resources.

Sign in / Sign up

Export Citation Format

Share Document