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Rodrigues R, Shet A, Swaroop N, Shastri S, Bogg L, De Costa A

WEAE0303 . Mobile phone adherence support for antiretroviral therapy: What would it cost the National AIDS Control Program in India?. Rodrigues R, Shet A, Swaroop N, Shastri S, Bogg L, De Costa A. St. John’s National Academy of Health Sciences, National AIDS Control Organisation

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Rodrigues R, Shet A, Swaroop N, Shastri S, Bogg L, De Costa A

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  1. WEAE0303 Mobile phone adherence support for antiretroviral therapy: What would it cost the National AIDS Control Program in India? Rodrigues R, Shet A, Swaroop N, Shastri S, Bogg L, De Costa A St. John’s National Academy of Health Sciences, National AIDS Control Organisation Bangalore, India Karolinska Institutet, Stockholm, Sweden

  2. Study Setting INDIA HIV prevalence : 0.3%* People with HIV: 2.5 million HIV patients on treatment: 0.4million# Bangalore Private teaching hospital with Government ART center Mysore Government teaching hospital and ART center *UNAIDS. Global Report 2010, #NACO March 2012

  3. Introduction • Good adherence defers failure to 1st line ART optimizes healthcare outcomes - reduces healthcare costs* • Interventions involving mobile telephones – found suitable for improving adherence#,@ – could reduce healthcare costs *World Health Organisation (2003) Adherence to Long-term Therapies #Weltel Kenya, @Prompting medication reminders- Cameroon

  4. Objective To assess the cost of weekly mobile phone reminders* for adherence support in the context of the Indian National AIDS control Program * HIVIND trial

  5. + Interactive Voice Response Call (IVR) Pictorial SMS The Mobile Phone Intervention Weekly Patient with mobile phone On Ry Weekly

  6. Assumptions This costing was from the program perspective: Hence, • Expenses in relation to the trial implementation were not considered • The technical providers of the intervention -considered most economical

  7. Costing Methodology The sequential procedure for costing was used: • Identifying the resource used in natural units (minutes/any other units) • Measuring resource use • Pricing the resource Sensitivity analysis for intervention scale up: • Varying the number of patients (IVR+SMS) • Varying the components of intervention ie; (i) SMS alone (ii) IVR alone and

  8. Costs • One time costs: Costs incurred for Intervention development • Recurrent Costs: • Fixed costs: Annual maintenance fee for equipment, staff cost, overheads • Variable cost: IVR and SMS cost/ patient, staff cost- intervention related • Total Costs: • One time cost + Fixed costs + n (variable costs)

  9. Results One time costs

  10. Fixed Cost

  11. Variable and Total costs/ patient

  12. Sensitivity analysis: Total and variable costs intervention scale up

  13. Sensitivity analysis:Cost for intervention scale-up (IVR+SMS) Patients Total cost of Intervention scale-up for 0.8 million patients: 0.16% of the 5year NACP VI budget

  14. Sensitivity analysis: Cost for IVR / SMS Scale-up *Total cost = One time + fixed cost + n (variable cost)

  15. Conclusion • The Indian National AIDS Control Program would incur an overall cost of 0.16% of its current 5year budget for mobile phone adherence support of ART • Given the current implementation costs, the intervention has the potential to improve health system effectiveness and enable the achievement of program goals in the Indian context

  16. The authors declare that they have no competing interests

  17. Thank you!!!

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