With millions more HIV-positive patients initiating antiretroviral therapy (ART),
there is a growing need for routine blood monitoring.
Point-of-care (POC) assays to monitor HIV-positive patients on ART have the potential to fill this gap in HIV care. Objective and Outcome Primary Objective: Estimate costs—including clinical and laboratory consumables,
and equipment—of monitoring ART using decentralized POC assays. Primary Outcome:Estimated cost of POC versus centralized laboratory...
A cost analysis was conducted from the clinic perspective using a micro-costing approach for the following POC tests: HIV viral load (VL) (Xpert® HIV-1 VL by Cepheid),
serum creatinine (Nova StatSensor® Xpress-i™ Creatinine),
and CD4 count (Alere Pima™ CD4). For each POC test,
the cost of medical consumables,
and POC testing equipment were collected.
For each test conducted at centralized laboratories,
the following were collected: medical consumables,
and public or...
Cost of Monitoring Patients (USD) Table 1 summarizes the costs of panels of ART monitoring tests for the initiating visit,
first year on ART,
and annual visits for stable patients.
Excludes equipment and recurring laboratory costs. Figure 3.
Cost per Panel Including Equipment Costs (USD) These analyses included total costs of equipment over a five year lifetime ($35,753) spread over increasing patient loads. Figure 4.
Summary of Costs (USD) Summary of Findings Full panel of ART...
This research suggests that widespread POC testing is a potentially cost-saving option to increase testing capacity in limited resource settings for ART monitoring.
While the cost of equipment setup and maintenance could be a barrier for clinics with small patient loads,
in clinics with higher patient loads,
the cost savings per test is significant enough to offset the initial investment. Limitations: This analysis does not take into account patient outcomes or costs of scale up for national...
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Short Bio (max. 150 words or less)
Kate Simeon is a second-year medical student at the University of Washington School of Medicine with interests in global health,
and medical innovation.
This research is a culmination of work completed in Summer 2017 for the Medical Student Research Training Program (MSRTP) at the University of Washington and was conducted alongside faculty at the University of Washington as well as researchers from the Centre for the AIDS Programme of Research in South Africa (CAPRISA)...