Boosting Compliance With HIV Rx

HIV on a macrophage.

It is well known that retention in care is directly linked to viral suppression in HIV-infected patients and reduces HIV transmission to partners.¹ Several studies have reported interventions to enhance patient retention, but the cost-effectiveness of these interventions is currently unknown.

A new study published in Acquired Immune Deficiency Syndromes was designed to examine the cost-effectiveness of interventions designed to increase patient retention.² The trial included 6 academically affiliated HIV clinics that randomized patients to receive either enhanced personal contact along with basic HIV education or the just the normal standard of care.² Researchers defined successful care retention as having at least at least 1 primary care visit in each 4-month interval over a 12-month period.

45.7% (280/613) of patients in the standard of care arm achieved visit constancy compared with 55.8% (343/615) of patients in the intervention arm (relative improvement 22.1%; 95% CI, 9%-36%; P < .01).

The investigators calculated all the costs associated with this intervention to assess its cost-effectiveness.²

• The total annual cost of the intervention at the 6 clinics was $241,565.

• The average cost per patient was $393.

• The estimated cost per additional patient retained in care beyond standard of care was $3834.

The study shows that interventions designed to retain HIV patients can be delivered at low cost, and that such interventions are effective in increasing visit frequency over a 12-month period. This study highlights that low-cost interventions can improve adherence for HIV-infected patients.²

References:

1. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493-505.

2. Shrestha RK, Gardner L, Marks G, et al. Estimating the cost of increasing retention in care for HIV-infected patients: results of the CDC/HRSA Retention in Care Trial. J Acquir Immune Defic Syndr. 2014 Dec 2; [Epub ahead of print].