A meta-analysis approach for estimating average unit costs for ART using pooled facility-level primary data from...

Area of Science:

• Health Economics
• Public Health
• HIV/AIDS Research

Background:

• Estimating the cost of Antiretroviral Therapy (ART) services is crucial for effective HIV/AIDS program planning and resource allocation.
• Significant variations in ART service costs exist across different healthcare facilities and countries in Africa.
• Standardizing cost data from diverse studies is challenging but necessary for reliable analysis.

Purpose of the Study:

• To estimate the average facility-level cost for ART services in Africa.
• To analyze the unit cost variations of ART services based on facility-level data.
• To provide evidence for funders and policymakers involved in HIV intervention scale-up.

Main Methods:

• Conducted a literature search to identify relevant facility-level cost studies for ART programs.
• Standardized disparate data from four studies across five African countries (139 facilities).
• Employed descriptive statistics and meta-analysis to estimate cost per patient and assess variations.

Main Results:

• The weighted average cost per patient on ART was $251 (95% CI: 193-308) in 2017 US dollars.
• Antiretroviral (ARV) drug costs constituted the largest proportion (46%) of the mean unit cost.
• Significant variations in unit costs were observed between countries, with a negative relationship between cost and patient volume.

Conclusions:

• The study successfully pooled and standardized ART costs from heterogeneous sources, enabling exploration of unit cost variations.
• The findings offer valuable insights into ART service costs, aiding decision-making for HIV intervention design and scaling.
• This methodology provides a framework for estimating costs from diverse datasets, reconciling differences across studies.