1 / 12

The financial implications of the 2010 WHO recommendations for ART in resource-limited settings

The financial implications of the 2010 WHO recommendations for ART in resource-limited settings. Lori Bollinger, John Stover and Carlos Avila Vienna International AIDS Conference 21 July 2010. Background. New antiretroviral therapy (ART) guidelines published in July 2010

sharne
Download Presentation

The financial implications of the 2010 WHO recommendations for ART in resource-limited settings

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The financial implications of the 2010 WHO recommendations for ART in resource-limited settings Lori Bollinger, John Stover and Carlos Avila Vienna International AIDS Conference 21 July 2010

  2. Background • New antiretroviral therapy (ART) guidelines published in July 2010 • Developed during 2009 through a consultative process led by World Health Organization • Part of process was to evaluate financial implications of proposed guidelines • Model developed to perform this evaluation • Switching eligibility criterion to CD4<350 • Switching ARV regimen (away from d4T)

  3. Methodology • Model tracks the HIV+ population by CD4 count • Results for impact on number needing ART are presented separately • Increases ART need by about 50% • Two ARV regimen scenarios presented here • “Fast” phase-out of d4T: 24% of total by 2012 • “Slow” phase-out of d4T: 38% of total by 2012 • Costs include: • ARV costs per patient per year • Laboratory costs (US$180/pppy) • Service delivery costs • Outreach and testing costs

  4. ARV costs (US$)

  5. Service delivery costs combine median number of IPD/OPV with WHO-CHOICE country-specific cost per visit

  6. Outreach and testing costs • Patients with symptoms of HIV (none) • STI patients (none) • TB patients (none) • Pregnant women (none – assumed in PMTCT costs) • Other health system contacts (US$16) • Sex workers (US$1 – HIV test cost only) • MSM (US$1 – HIV test cost only) • Injecting drug users (US$1 – HIV test cost only) • VCT (US$16) • General population (US$23)

  7. Scenarios for results (again) • Switch eligibility criteria to CD4<350 • Overall ART need increases by about 50% • Two scenarios: • Fast phase-out of d4T – 24% of total by 2012 • Slow phase-out of d4T – 38% of total by 2012 • Reach 80% coverage of those needing ART by 2015

  8. Results: Total resources required for ART (2009 US$)

  9. Results: Breakdown of cumulative resources required 2010-2015

  10. Results: Cost-effectiveness implications

  11. Summary and Conclusions • Increasing the eligibility criterion and phasing out d4T results in annual ART costs ranging between US$3.5 billion in 2010 and US$9.5 billion by 2015 • Once criterion changes, costs are split in thirds: 1/3 to ARVs, 1/3 to labs and 1/3 split evenly between service delivery and testing • Testing costs are significantly lower before change • Cost per person year on ART is US$800, while the cost per death averted is about US$10,000 • Implementing a faster phase-out of d4T does not have a large impact on overall costs

  12. The financial implications of the 2010 WHO recommendations for ART in resource-limited settings Lori Bollinger, John Stover and Carlos Avila Vienna International AIDS Conference 21 July 2010

More Related