Low-cost interventions can improve compliance with HIV therapy, which is directly linked to viral suppression and reduced transmission to partners.
HIV on a macrophage.
It is well known that retention in care is directly linked to viral suppression in HIV-infected patients and reduces HIV transmission to partners.1 Several studies have reported interventions to enhance patient retention, but the cost-effectiveness of these interventions is currently unknown.
A new study published in Acquired Immune Deficiency Syndromes was designed to examine the cost-effectiveness of interventions designed to increase patient retention.2 The trial included 6 academically affiliated HIV clinics that randomized patients to receive either enhanced personal contact along with basic HIV education or the just the normal standard of care.2 Researchers defined successful care retention as having at least at least 1 primary care visit in each 4-month interval over a 12-month period.
45.7% (280/613) of patients in the standard of care arm achieved visit constancy compared with 55.8% (343/615) of patients in the intervention arm (relative improvement 22.1%; 95% CI, 9%-36%; P < .01).
The investigators calculated all the costs associated with this intervention to assess its cost-effectiveness.2
• The total annual cost of the intervention at the 6 clinics was $241,565.
• The average cost per patient was $393.
• The estimated cost per additional patient retained in care beyond standard of care was $3834.
The study shows that interventions designed to retain HIV patients can be delivered at low cost, and that such interventions are effective in increasing visit frequency over a 12-month period. This study highlights that low-cost interventions can improve adherence for HIV-infected patients.2
1. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493-505.
2. Shrestha RK, Gardner L, Marks G, et al. Estimating the cost of increasing retention in care for HIV-infected patients: results of the CDC/HRSA Retention in Care Trial. J Acquir Immune Defic Syndr. 2014 Dec 2; [Epub ahead of print].