赞比亚的差异化ART服务交付策略的成本和有效性:使用例行数据的建模分析
Nkgomeleng A Lekodeba1, Sydney Rosen1,2, Bevis Phiri3
1Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Journal of the International AIDS Society
|June 28, 2025
概括
在赞比亚扩大为期6个月的抗逆转录病毒治疗 (ART) 药物分发 (6MMD) 是节省成本和改善病毒抑制. 通过将6MMD与坚持群体和有针对性的DSD模型相结合,可以获得进一步的收益.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 艾滋病毒/艾滋病 治疗
背景情况:
- 针对抗逆转录病毒治疗 (ART) 的差异化服务交付 (DSD) 模式在撒哈拉以南非洲被广泛使用,以提高以患者为中心的护理和效率.
- 确定具有成本效益的DSD模型组合对于优化ART程序扩展至关重要.
研究的目的:
- 为了确定DSD模型的成本效益组合在赞比亚的ART交付.
- 评估不同DSD模型对病毒抑制,保留和客户和提供者的成本的影响.
主要方法:
- 使用赞比亚的回顾性ART客户端数据 (2018-2022) 开发了一个数学模型.
- 该模型分析了各种DSD模型组合的结果 (病毒抑制,保留) 和成本.
- 增量成本效益比率 (ICER) 从提供者的角度计算.
主要成果:
- 发现六种DSD模型组合处于成本效益边界.
- 仅6个月的药物发行 (6MMD) 节省了成本,改善了病毒的保留和抑制,同时降低了客户的成本.
- 其他具有成本效益的组合包括6MMD与附加组 (AG) 和仅AG,尽管客户成本增加.
结论:
- 数学建模可以有效地识别用于ART交付的最佳DSD模型组合.
- 在赞比亚扩大6MMD的规模是节省成本和有利于病毒抑制.
- 针对性地应用特定的DSD模型可以进一步提高不同客户群体的健康收益.
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