Table 1 Sources of estimates used in analysis
From: Cost effectiveness of a computer-delivered intervention to improve HIV medication adherence
Estimate | Source | Effect of intervention |
|---|---|---|
Treatment Costs | ||
Cost of Medications | Based on participants’ actual antiretroviral regimens with costs based on current average prices in 2012[39]. The average annual cost per patient if fully adherent was $22,675. | Increased use of medications because of increased adherence increases costs of medications |
Inpatient and Outpatient Treatment by CD4 count | Based on data from Gebo et al. [30] adjusted to 2012 dollars reduced by medication costs that were calculated directly (above). Costs vary by patient CD4 count, with an overall average annual cost of $13,296 | Improved health may increase cheaper outpatient care use but decrease more expensive inpatient care |
Development Costs | ||
Salary, Wages, Software, Consultants, Hardware, Space, Media, Testing, Test Deployment for study | Actual costs as recorded in records of grant expenditures (detailed in Table 3) | |
Costs to participants during development | Loss of salary and wages – estimate of lost salary and wages by participants who reported working based on their education level [32]. | |
Cost of transportation -- from actual participant reimbursement during development ($5.00 for daily bus fare in our area). | ||
Deployment costs – Office Kiosk Scenario | ||
Space, computers, maintenance, staff, electricity | Cost of office space from based on industry report [36] | |
Cost of computer purchase, operation, and maintenance based on industry report [35] | ||
Staff time costs based on average hourly wage for medical assistant plus fringe benefits and administrative costs (from US Bureau of Labor Statistics and institutional fringe benefit and administrative cost rates) | ||
Software License | Nominal fee assumed to defray costs of duplication of media and shipping (assumption) | |
Transportation for rural patients | Average distance for rural patients to visit specialist practitioner from Rosenthal et al. [37] and average cost per mile of transportation [38] via mid-size sedan per the American Automobile Association | |
Lost salary and wages | Based on estimates obtained during development for representative number of patients based on time lost and salary calculated from participants’ educational status [32] | |
Cost of computer and high speed Internet access at home | Considered to be part of patients’ regular cost of living, as the actual cost of one hour of computer and Internet usage is small | |
Deployment costs – Web Deployment Scenario | ||
Server operation and maintenance | Page et al. 2012 [44]. | |
Advertising | Page et al. 2012 [44]; amount increased for larger number of users | |
Technical Support | Page et al. 2012 [44]. | |
Utilities | ||
Numeric value of a specific health status (more or less ill) based on immune function reflected in CD4 (immune cell) count | Kauf et al. 2008 [29]. | Improved adherence will improve immune function and thus health status, enhance patients’ quality of life |