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Cost-Effectiveness of HRSA's Ryan White HIV/AIDS Program?
Ravi Goyal1, Dara Luca1, Pamela W Klein2
1Mathematica, Inc.
Journal of Acquired Immune Deficiency Syndromes (1999)
|October 23, 2020
Summary
The Ryan White HIV/AIDS Program (RWHAP) significantly improves viral suppression and reduces HIV infections and deaths. This vital public health program demonstrates strong cost-effectiveness in managing the HIV epidemic.
Area of Science:
- Public Health
- Health Economics
- Epidemiology
Background:
- The Ryan White HIV/AIDS Program (RWHAP) is a major US public funder for HIV care, with an annual budget exceeding $2 billion.
- Limited analysis exists on the long-term public health and economic impacts of the RWHAP.
Purpose of the Study:
- To quantify the long-term public health and economic impacts of the RWHAP.
- To compare health outcomes and costs with and without the RWHAP over a 50-year period.
Main Methods:
- An agent-based, stochastic model was employed to simulate health care costs and outcomes.
- A conservative assumption was made that only uninsured individuals would lose access to services without the RWHAP.
Main Results:
- The RWHAP is projected to increase viral suppression by 25.2 percentage points (82.6% vs. 57.4%).
- The program is associated with 18% fewer new HIV infections, 31% fewer deaths, 5.6 million more quality-adjusted life years, and a 25% increase in cumulative healthcare costs ($165 billion).
- The incremental cost-effectiveness ratio was calculated at $29,573 per quality-adjusted life year gained.
Conclusions:
- The RWHAP is highly cost-effective, falling below the US per capita GDP threshold.
- The RWHAP plays a critical role in the US public health response to the HIV epidemic.