Estimating age-based antiretroviral therapy costs for HIV-infected children in resource-limited settings based on World Health Organization weight-based dosing recommendations

BMC Health Services Research

Andrea Ciaranello³  Stephen Resch²  Charles Holmes⁵  Martina Penazzato¹  Shaffiq Essajee⁶  Kathleen Doherty⁴ 

[1] Clinical Trial Unit Medical Research Council, London, UK;Center for Health Decision Science, Harvard School of Public Health, Boston, MA, USA;Medical Practice Evaluation Center, Divisions of General Medicine and Infectious Disease, Massachusetts General Hospital, Boston, MA, USA;Medical Practice Evaluation Center, Divisions of General Medicine, Massachusetts General Hospital, Boston, MA, USA;Center for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia;Clinton Health Access Initiative, Boston, MA, USA

关键词: Costs;    Pediatric HIV;    Antiretroviral therapy;   

Others  :  1131302
DOI  :  10.1186/1472-6963-14-201

 received in 2013-07-08, accepted in 2014-04-02,  发布年份 2014

【 摘 要 】

Background

Pediatric antiretroviral therapy (ART) has been shown to substantially reduce morbidity and mortality in HIV-infected infants and children. To accurately project program costs, analysts need accurate estimations of antiretroviral drug (ARV) costs for children. However, the costing of pediatric antiretroviral therapy is complicated by weight-based dosing recommendations which change as children grow.

Methods

We developed a step-by-step methodology for estimating the cost of pediatric ARV regimens for children ages 0–13 years old. The costing approach incorporates weight-based dosing recommendations to provide estimated ARV doses throughout childhood development. Published unit drug costs are then used to calculate average monthly drug costs. We compared our derived monthly ARV costs to published estimates to assess the accuracy of our methodology.

Results

The estimates of monthly ARV costs are provided for six commonly used first-line pediatric ARV regimens, considering three possible care scenarios. The costs derived in our analysis for children were fairly comparable to or slightly higher than available published ARV drug or regimen estimates.

Conclusions

The methodology described here can be used to provide an accurate estimation of pediatric ARV regimen costs for cost-effectiveness analysts to project the optimum packages of care for HIV-infected children, as well as for program administrators and budget analysts who wish to assess the feasibility of increasing pediatric ART availability in constrained budget environments.

【 授权许可】

   
2014 Doherty et al.; licensee BioMed Central Ltd.

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