Background: 

The patient-centered HIV care model (PCHCM) is an evidence-informed structural intervention that integrates community-based pharmacists with primary medical providers to improve rates of HIV viral suppression. This report assesses the costs and cost-effectiveness of the PCHCM.

Setting: 

Patient-centered HIV care model.

Methods: 

Three project sites, each composed of a medical clinic and 1 or 2 community-based HIV-specialized pharmacies, were included in the analyses. PCHCM required patient data sharing between medical providers and pharmacists and collaborative therapy-related decision making. Intervention effectiveness was measured as the incremental number of patients virally suppressed (HIV RNA <200 copies/mL at the last test in a 12-month measurement period). Microcosting direct measurement methods were used to estimate intervention costs. The cost per patient, cost per patient visit, and incremental cost per patient virally suppressed were calculated from the health care providers' perspective. Additionally, the number of HIV transmissions averted, lifetime HIV treatment cost saved, quality-adjusted life years (QALYs) saved, and cost per QALY saved were calculated from the societal perspective, using standard methods and reported values from the published literature.

Results: 

Overall, the PCHCM annual intervention cost for the 3 project sites was $226,741. The average cost per patient, cost per patient visit, and incremental cost per patient virally suppressed were $813, $48, and $5,039, respectively. The intervention averted 2.75 HIV transmissions and saved 12.22 QALYs and nearly $1.28 million in lifetime HIV treatment costs. The intervention was cost saving overall and at each project site.

Conclusions: 

The PCHCM can be delivered at a relatively low cost and is a cost-saving intervention to assist patients in achieving viral suppression and preventing HIV transmission.

中文翻译：

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以患者为中心的艾滋病毒护理模式的成本和成本效益：基于社区的药剂师和基层医疗提供者之间的合作

背景： 

以患者为中心的HIV护理模型（PCHCM）是一种以信息为依据的结构干预措施，将基于社区的药剂师与主要医疗提供者相结合，以提高HIV病毒抑制率。该报告评估了PCHCM的成本和成本效益。

设置： 

以病人为中心的艾滋病护理模式。

方法： 

分析中包括三个项目站点，每个站点由一个医疗诊所和1或2个基于社区的HIV专业药房组成。PCHCM需要在医疗提供者和药剂师之间共享患者数据，以及与协作疗法相关的决策。干预效果的衡量标准是被病毒抑制的患者人数的增加（在12个月的测量期内，最后一次检测的HIV RNA <200拷贝/ mL）。微观成本直接测量方法用于估算干预成本。从卫生保健提供者的角度计算了每位患者的费用，每位患者就诊的费用以及每位被病毒抑制的患者的增量费用。此外，艾滋病毒的数量从社会的角度，使用标准方法和已发表文献的报告值，从社会角度计算了避免传播的途径，节省了终生的HIV治疗费用，节省了质量调整生命年（QALYs）以及节省的每QALY费用。

结果： 

总体而言，这3个项目地点的PCHCM年度干预成本为226,741美元。每位患者的平均成本，每位患者就诊的成本以及每位被病毒抑制的患者的增量成本分别为813美元，48美元和5039美元。这项干预措施避免了2.75次HIV传播，节省了12.22个QALY，并节省了近128万美元的终生HIV治疗费用。整个项目以及每个项目现场的干预都节省了成本。

结论： 

PCHCM可以相对较低的成本提供，是一种节省成本的干预措施，可帮助患者实现病毒抑制和预防HIV传播。