Cost-effectiveness of clinical interventions for AIDS wasting

Area of Science:

• Health Economics
• Clinical Nutrition
• HIV/AIDS Management

Background:

• Economic evaluations of HIV/AIDS interventions are crucial for optimizing cost-effective patient care.
• AIDS wasting syndrome presents significant challenges, necessitating effective and affordable treatment strategies.

Purpose of the Study:

• To conduct a cost-effectiveness analysis of three interventions for AIDS wasting: nutritional counseling (NC), nutritional counseling with oxandrolone (OX), and nutritional counseling with progressive resistance training (PRT).
• To adapt findings from a clinical trial to an estimated community model (ECM) for broader healthcare applicability.

Main Methods:

• A three-arm clinical trial involving 50 patients with AIDS wasting was conducted.
• Costs were determined for the trial and an ECM, incorporating institutional and societal perspectives.
• Cost-effectiveness was assessed by comparing intervention costs to quality-adjusted life-year (QALY) gains.

Main Results:

• From a societal perspective, the cost per QALY ranged from $55,000 (NC) to $151,000 (OX) and $65,000 (PRT).
• From an institutional perspective, the cost per QALY was $45,000 (NC), $147,000 (OX), and $31,000 (PRT).
• PRT demonstrated the highest cost-effectiveness, especially from an institutional viewpoint, while oxandrolone was the least cost-effective.

Conclusions:

• Cost-effectiveness analyses can be successfully adapted from clinical trials to community settings.
• Progressive resistance training (PRT) is the most cost-effective intervention for managing AIDS wasting.
• Third-party payers should consider covering PRT as a valuable treatment option for AIDS wasting.