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Resource Needs for Care and Treatment

Resource Needs for Care and Treatment

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Resource Needs for Care and Treatment

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  1. Resource Needs for Care and Treatment

  2. Types of care and treatment • Five types: • Diagnostic HIV testing • Palliative care • Treatment of Opportunistic Infections (OIs) • Opportunistic Infections prophylaxis • ARV + laboratory support • Nutritional support • 2nd line • TB

  3. Basic principles • Three factors: • Population target group • Access • Per patient cost (annual or life-time) • Total cost = Persons needing treatment X % needing treatment with access to it X unit cost of the treatment

  4. Default Unit Costs

  5. People needing care • The annual cohort that requires attention are those people living with HIV who are newly symptomatic • Plus: • Survivors on treatment • Survivors without treatment

  6. One-time costs • Palliative and OI treatment costs • Lifetime costs counted once • HIV testing • One-time cost for diagnosis prior to OI treatment • Default unit cost include counseling costs

  7. Ongoing treatment • Those needing ongoing treatment (ARV and OI prophylaxis) include: • Percentage of newly symptomatic • 100% of those treated last year who survive

  8. Current access • Palliative care coverage is estimated using access to other health services • OI tx, OI prophylaxis & ARV estimated from coverage survey (and 3x5 data)

  9. Growth rates • Once the baseline has been estimated, growth capacity of services are estimated • Growth rates estimated using growth between 2004 and of 2005 • Maximum feasible coverage defined at 85% • Cap on coverage affects newly needing but not survivors on treatment

  10. Per patient cost data • Data from workshops and WHO

  11. How many years? • Expected life extension is uncertain • Here, assume 3-5 additional of life from ARVs • Poisson distribution used to approximate each year’s share of deaths

  12. Total costs • Total costs = The number of persons receiving treatment for each year (newly requiring treatment plus those surviving, if relevant) * per patient cost of treatment

  13. Regional distribution, 2008 1% 7% 15% 55% 17% 5% Africa S/SE Asia E Asia/Pac LAC E Europe NA/ME

  14. Distribution by intervention, 2008 2% 6% <1% 13% 10% 69% Palliative Testing OI Tx OI Proph ARVs ARVs Labs