Potential health gains in West and Central Africa through savings from lower cost HIV treatment
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Potential health gains in West and Central Africa through savings from lower cost HIV treatment. / Stuart, Robyn M.; Kelly, Sherrie L.; Martin-Hughes, Rowan; Wilson, David P.
In: AIDS, Vol. 34, No. 3, 2020, p. 439-446.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Potential health gains in West and Central Africa through savings from lower cost HIV treatment
AU - Stuart, Robyn M.
AU - Kelly, Sherrie L.
AU - Martin-Hughes, Rowan
AU - Wilson, David P.
PY - 2020
Y1 - 2020
N2 - Objective::Prices of antiretroviral (ARV) drugs in lower income countries have decreased substantially over the past two decades, helping to facilitate greatly expanded access to antiretroviral therapy (ART). However, ART coverage in many parts of the world remains low. We investigate the extent of epidemiological benefits that might be expected if ARV drug prices decline further.Design:A modeling study using data from seven countries in West and Central Africa (Cameroon, Democratic Republic of the Congo, Côte d'Ivoire, Niger, Nigeria, Senegal, and Togo).Methods:We investigated how the timing of ARV cost reductions could affect the impact and compared three different possible investment strategies: reinvesting in ART, reinvesting in the HIV response according to historical allocations, and reinvesting with the aim of minimizing HIV incidence and mortality.Results:If ARV drug prices fell by 37% relative to 2018 levels (i.e. following continued trend declines), we calculate ART unit costs could decrease by ∼20% (holding other cost components constant). If this could be achieved by 2020 and the savings were reinvested into ART, we estimate that an additional 8% of HIV infections and 11% of HIV-related deaths could be averted over 2020-2030 across the seven countries. Slightly greater gains could be attained if funds were reinvested in ART in combination with primary prevention. Delays in the year of introduction of ARV price reductions would reduce the impact by about 1% per year.Conclusion:ARV price reductions could free up funds that - if strategically invested - would help countries move closer toward the elimination of HIV.
AB - Objective::Prices of antiretroviral (ARV) drugs in lower income countries have decreased substantially over the past two decades, helping to facilitate greatly expanded access to antiretroviral therapy (ART). However, ART coverage in many parts of the world remains low. We investigate the extent of epidemiological benefits that might be expected if ARV drug prices decline further.Design:A modeling study using data from seven countries in West and Central Africa (Cameroon, Democratic Republic of the Congo, Côte d'Ivoire, Niger, Nigeria, Senegal, and Togo).Methods:We investigated how the timing of ARV cost reductions could affect the impact and compared three different possible investment strategies: reinvesting in ART, reinvesting in the HIV response according to historical allocations, and reinvesting with the aim of minimizing HIV incidence and mortality.Results:If ARV drug prices fell by 37% relative to 2018 levels (i.e. following continued trend declines), we calculate ART unit costs could decrease by ∼20% (holding other cost components constant). If this could be achieved by 2020 and the savings were reinvested into ART, we estimate that an additional 8% of HIV infections and 11% of HIV-related deaths could be averted over 2020-2030 across the seven countries. Slightly greater gains could be attained if funds were reinvested in ART in combination with primary prevention. Delays in the year of introduction of ARV price reductions would reduce the impact by about 1% per year.Conclusion:ARV price reductions could free up funds that - if strategically invested - would help countries move closer toward the elimination of HIV.
KW - Allocative efficiency
KW - Antiretrovirals
KW - Mathematical modelling
UR - http://www.scopus.com/inward/record.url?scp=85078690197&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000002419
DO - 10.1097/QAD.0000000000002419
M3 - Journal article
C2 - 31996595
AN - SCOPUS:85078690197
VL - 34
SP - 439
EP - 446
JO - AIDS
JF - AIDS
SN - 1350-2840
IS - 3
ER -
ID: 243062685