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Cost-Effectiveness of Preventing Loss to Follow-up in HIV Treatment Programs: A Côte d'Ivoire Appraisal

Author

Listed:
  • Elena Losina
  • Hapsatou Touré
  • Lauren M Uhler
  • Xavier Anglaret
  • A David Paltiel
  • Eric Balestre
  • Rochelle P Walensky
  • Eugène Messou
  • Milton C Weinstein
  • François Dabis
  • Kenneth A Freedberg
  • for the ART-LINC Collaboration of International Epidemiological Databases to Evaluate AIDS (IeDEA)
  • and the CEPAC International investigators

Abstract

Based on data from West Africa, Elena Losina and colleagues predict that interventions to reduce dropout rates from HIV treatment programs (such as eliminating copayments) will be cost-effective.Background: Data from HIV treatment programs in resource-limited settings show extensive rates of loss to follow-up (LTFU) ranging from 5% to 40% within 6 mo of antiretroviral therapy (ART) initiation. Our objective was to project the clinical impact and cost-effectiveness of interventions to prevent LTFU from HIV care in West Africa. Methods and Findings: We used the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) International model to project the clinical benefits and cost-effectiveness of LTFU-prevention programs from a payer perspective. These programs include components such as eliminating ART co-payments, eliminating charges to patients for opportunistic infection-related drugs, improving personnel training, and providing meals and reimbursing for transportation for participants. The efficacies and costs of these interventions were extensively varied in sensitivity analyses. We used World Health Organization criteria of

Suggested Citation

  • Elena Losina & Hapsatou Touré & Lauren M Uhler & Xavier Anglaret & A David Paltiel & Eric Balestre & Rochelle P Walensky & Eugène Messou & Milton C Weinstein & François Dabis & Kenneth A Freedberg & f, 2009. "Cost-Effectiveness of Preventing Loss to Follow-up in HIV Treatment Programs: A Côte d'Ivoire Appraisal," PLOS Medicine, Public Library of Science, vol. 6(10), pages 1-11, October.
    • Handle: RePEc:plo:pmed00:1000173
    DOI: 10.1371/journal.pmed.1000173
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