Costs of home-delivered antiretroviral therapy refills for persons living with HIV: Evidence from a pilot randomized controlled trial in KwaZulu-Natal, South Africa

• DOI: 10.1371/journal.pgph.0003368
• Publication Date: 2024-12-30T18:29:48Z
• Authors: Ashley S. Tseng; Ruanne V. Barnabas; Alastair van Heerden; Xolani Ntinga; Maitreyi Sahu
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Public aspects of medicine; RA1-1270; Article; Research Article

Antiretroviral therapy (ART) is needed across the lifetime to maintain viral suppression for people living with HIV. In South Africa, obstacles reliable access ART persist and are magnified in rural areas, where HIV services also typically costlier deliver. A recent pilot randomized study (the Deliver Health Study) found that home-delivered refills, provided at a low user fee, effectively overcame logistical barriers improved clinical outcomes Africa. present costing using provider perspective, we conducted retrospective activity-based micro-costing of within Study when at-scale (in setting), compared facility-based costs provincial expenditure data (covering both urban settings). Within context which had an average three deliveries per day days week, cost 2022 USD) $794 first year $714 subsequent years client after subtracting fees, $167 clinic-based care. We estimated can reasonably be scaled up 12 home five week setting. When delivered at-scale, $267 $183 client. Average delivery further decreased increasing duration refills from three-months six- 12-month scripts (from $177 $135 client, respectively). Personnel were largest while drug refills. setting not only offers benefits hard-to-reach population but comparable standard