2016
DOI: 10.7448/ias.19.5.20840
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Annual cost of antiretroviral therapy among three service delivery models in Uganda

Abstract: IntroductionIn response to the increasing burden of HIV, the Ugandan government has employed different service delivery models since 2004 that aim to reduce costs and remove barriers to accessing HIV care. These models include community-based approaches to delivering antiretroviral therapy (ART) and delegating tasks to lower-level health workers. This study aimed to provide data on annual ART cost per client among three different service delivery models in Uganda.MethodsCosting data for the entire year 2012 we… Show more

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Cited by 26 publications
(18 citation statements)
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“…These include community ART groups, fixed community mobile ART clinics, home delivery of ART and multi-month ART prescription among others which can be implemented to compliment the current approach of facility-based model. These interventions are less costly to the clients and reduce number of clinic visits which is favourable to the patients [45][46][47][48][49][50]. In addition, they likely reduce workload of health care workers hence reduce the probability of speaking unfavourably to clients due to fatigue.…”
Section: Discussionmentioning
confidence: 99%
“…These include community ART groups, fixed community mobile ART clinics, home delivery of ART and multi-month ART prescription among others which can be implemented to compliment the current approach of facility-based model. These interventions are less costly to the clients and reduce number of clinic visits which is favourable to the patients [45][46][47][48][49][50]. In addition, they likely reduce workload of health care workers hence reduce the probability of speaking unfavourably to clients due to fatigue.…”
Section: Discussionmentioning
confidence: 99%
“…Based on a review of recent country-specific studies, we estimated ranges for the cost per clinical and ARV refill visit of facility-level overhead (e.g., for utilities) and personnel costs (e.g., for health workers who directly deliver treatment interventions). Data from 10 studies across 11 countries were included in the analysis [50][51][52][53][54][55][56][57][58]. We assumed the unit costs would be higher as country income levels increased.…”
Section: Estimating Art Unit Costsmentioning
confidence: 99%
“…Few studies estimate community-based ART costs. Community-based ART cost ranges were derived from four studies [15,55,59,60]. The analysis assumes communitybased ART programs cost more in rural than urban areas [13].…”
Section: Estimating Art Unit Costsmentioning
confidence: 99%
“…Finally, ART drug costs account for about a quarter of cost of HIV care in SA (it is a greater proportion in countries where salaries are lower and laboratory monitoring is more limited); therefore, attention to systemic cost drivers are still needed. [7,10] If successful, patients will benefit with a much safer and more forgiving regimen in a smaller tablet, government and other funders will save money, while pharmaceutical producers will have simplified manufacturing, using lower volumes of active pharmaceutical ingredients. In an age of escalating medical costs, we are seldom presented with a win-win scenario with regard to clinical care.…”
Section: Resultsmentioning
confidence: 99%