Only 63% of people living with HIV in the United States are achieving viral suppression. Structural and social barriers limit adherence to antiretroviral therapy which furthers the HIV epidemic while increasing health care costs. This study calculated the cost and cost-effectiveness of a contingency management intervention with cash incentives. People with HIV and detectable viral loads were randomized to usual care or an incentive group. Individuals could earn up to $3650 per year if they achieved and maintained an undetectable viral load. The average 1-year intervention cost, including incentives, was $4105 per patient. The average health care costs were $27,189 per patient in usual care and $35,853 per patient in the incentive group. We estimated a cost of $28,888 per quality-adjusted life-year (QALY) gained, which is well below accepted cost-per-QALY thresholds. Contingency management with cash incentives is a cost-effective intervention for significantly increasing viral suppression.

中文翻译：

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艾滋病病毒感染者病毒抑制激励措施的成本和成本效益。

在美国，只有 63% 的 HIV 感染者实现了病毒抑制。结构和社会障碍限制了抗逆转录病毒疗法的依从性，这会加剧艾滋病毒的流行，同时增加医疗保健费用。本研究计算了采用现金奖励的应急管理干预措施的成本和成本效益。携带 HIV 和可检测到病毒载量的人被随机分配到常规护理组或激励组。如果达到并保持无法检测到的病毒载量，个人每年可以赚取高达 3650 美元。包括奖励在内的平均 1 年干预成本为每位患者 4105 美元。常规护理中每位患者的平均医疗保健费用为 27,189 美元，激励组中每位患者的平均医疗费用为 35,853 美元。我们估计每个质量调整生命年 (QALY) 的成本为 28,888 美元，这远低于公认的每 QALY 成本阈值。带有现金奖励的应急管理是显着增加病毒抑制的一种具有成本效益的干预措施。