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The per-patient costs of HIV services in South Africa: Systematic review and application in the South African HIV Investment Case

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  • Gesine Meyer-Rath
  • Craig van Rensburg
  • Calvin Chiu
  • Rahma Leuner
  • Lise Jamieson
  • Steve Cohen

Abstract

Background: In economic analyses of HIV interventions, South Africa is often used as a case in point, due to the availability of good epidemiological and programme data and the global relevance of its epidemic. Few analyses however use locally relevant cost data. We reviewed available cost data as part of the South African HIV Investment Case, a modelling exercise to inform the optimal use of financial resources for the country’s HIV programme. Methods: We systematically reviewed publication databases for published cost data covering a large range of HIV interventions and summarised relevant unit costs (cost per person receiving a service) for each. Where no data was found in the literature, we constructed unit costs either based on available information regarding ingredients and relevant public-sector prices, or based on expenditure records. Results: Only 42 (5%) of 1,047 records included in our full-text review reported primary cost data on HIV interventions in South Africa, with 71% of included papers covering ART. Other papers detailed the costs of HCT, MMC, palliative and inpatient care; no papers were found on the costs of PrEP, social and behaviour change communication, and PMTCT. The results informed unit costs for 5 of 11 intervention categories included in the Investment Case, with the remainder costed based on ingredients (35%) and expenditure data (10%). Conclusions: A large number of modelled economic analyses of HIV interventions in South Africa use as inputs the same, often outdated, cost analyses, without reference to additional literature review. More primary cost analyses of non-ART interventions are needed.

Suggested Citation

  • Gesine Meyer-Rath & Craig van Rensburg & Calvin Chiu & Rahma Leuner & Lise Jamieson & Steve Cohen, 2019. "The per-patient costs of HIV services in South Africa: Systematic review and application in the South African HIV Investment Case," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-15, February.
  • Handle: RePEc:plo:pone00:0210497
    DOI: 10.1371/journal.pone.0210497
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    References listed on IDEAS

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    1. Michel Tchuenche & Vibhuti Haté & Dacia McPherson & Eurica Palmer & Ananthy Thambinayagam & Dayanund Loykissoonlal & Emmanuel Njeuhmeli & Steven Forsythe, 2016. "Estimating Client Out-of-Pocket Costs for Accessing Voluntary Medical Male Circumcision in South Africa," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-10, October.
    2. Rochelle P Walensky & Robin Wood & Andrea L Ciaranello & A David Paltiel & Sarah B Lorenzana & Xavier Anglaret & Adam W Stoler & Kenneth A Freedberg & for the CEPAC-International Investigators, 2010. "Scaling Up the 2010 World Health Organization HIV Treatment Guidelines in Resource-Limited Settings: A Model-Based Analysis," PLOS Medicine, Public Library of Science, vol. 7(12), pages 1-12, December.
    3. Hanani Tabana & Lungiswa Nkonki & Charles Hongoro & Tanya Doherty & Anna Mia Ekström & Reshma Naik & Wanga Zembe-Mkabile & Debra Jackson & Anna Thorson, 2015. "A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-13, August.
    4. Paul Gavaza & Karen Rascati & Abiola Oladapo & Star Khoza, 2012. "The State of Health Economic Research in South Africa," PharmacoEconomics, Springer, vol. 30(10), pages 925-940, October.
    5. Omar Galárraga & Veronika Wirtz & Alejandro Figueroa-Lara & Yared Santa-Ana-Tellez & Ibrahima Coulibaly & Kirsi Viisainen & Antonieta Medina-Lara & Eline Korenromp, 2011. "Unit Costs for Delivery of Antiretroviral Treatment and Prevention of Mother-to-Child Transmission of HIV," PharmacoEconomics, Springer, vol. 29(7), pages 579-599, July.
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