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Cost Effectiveness and Resource Allocation
Published in: Cost Effectiveness and Resource Allocation 1/2017

Open Access 01-12-2017 | Research

Cost-effectiveness analysis of the national decentralization policy of antiretroviral treatment programme in Zambia

Authors: Shinsuke Miyano, Gardner Syakantu, Kenichi Komada, Hiroyoshi Endo, Tomohiko Sugishita

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2017

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Abstract

Background

In resource-limited settings with a high prevalence of human immunodeficiency virus (HIV) infection such as Zambia, decentralization of HIV/acquired immunodeficiency syndrome (HIV/AIDS) treatment and care with effective use of resources is a cornerstone of universal treatment and care.

Objectives

This research aims to analyse the cost effectiveness of the National Mobile Antiretroviral Therapy (ART) Services Programme in Zambia as a means of decentralizing ART services.

Methods

Cost-effectiveness analyses were performed using a decision analytic model and Markov model to compare the original ART programme, ‘Hospital-based ART’, with the intervention programme, Hospital-based plus ‘Mobile ART’, from the perspective of the district government health office in Zambia. The total cost of ART services, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were examined.

Results

The mean annual per-patient costs were 1259.16 USD for the original programme and 2601.02 USD for the intervention programme, while the mean number of QALYs was 6.81 for the original and 7.27 for the intervention programme. The ICER of the intervention programme relative to the original programme was 2965.17 USD/QALY, which was much below the willingness-to-pay (WTP), or three times the GDP per capita (4224 USD), but still over the GDP per capita (1408 USD). In the sensitivity analysis, the ICER of the intervention programme did not substantially change.

Conclusion

The National Mobile ART Services Programme in Zambia could be a cost-effective approach to decentralizing ART services into rural areas in Zambia. This programme could be expanded to more districts where it has not yet been introduced to improve access to ART services and the health of people living with HIV (PLHIV) in rural areas.
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Metadata
Title
Cost-effectiveness analysis of the national decentralization policy of antiretroviral treatment programme in Zambia
Authors
Shinsuke Miyano
Gardner Syakantu
Kenichi Komada
Hiroyoshi Endo
Tomohiko Sugishita
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Cost Effectiveness and Resource Allocation / Issue 1/2017
Electronic ISSN: 1478-7547
DOI
https://doi.org/10.1186/s12962-017-0065-8

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