Table 3.
Sensitivity analysis of costs of the mHealth intervention for ART adherence support based on the number of patients and type of mHealth intervention
| All costs in INR | Cost/year, 2012 (INR) | Cost/year (INR) 2017 | ||
|---|---|---|---|---|
| Number of ART centres | 380 [7] | 450a | 450 [24] | 600 [7, 22] |
| Number of languagesb | 23 | 23 | 23 | 23 |
| Number of patients (n) | 600,000 [7]c | 500,000 [23] | 800,000 [24] | 1,000,000 [7, 22] |
| Costs for intervention development based on languages included, i.e. (23 languages×2,000 INR per language/5) where 5 is the number of years one NACP cycle lasts | 9,200 | 9,200 | 9,200 | 9,200 |
| Co-ordination cost based on the number of ART centresd (i.e. ART center level cost from Tables 1×number of ART centres) | 20,691,000 | 24,502,500 | 24,502,500 | 32,670,000 |
| Total intervention cost (national programme-level cost+number of centres×centre-level cost+n×patient-level cost) | 57,278,690 | 55,054,190 | 73,162,190 | 93,401,690 |
| Intervention cost/patient/year=cost of (IVR+SMS reminder)/n | 96.46 (1.55 USD) | 110.11 (1.77 USD) | 91.45 (1.47 USD) | 93.40 (1.50 USD) |
| Total cost of only the IVR call (national programme-level cost+number of centres×centre-level cost+n×patient-level cost for IVR only) | 51,350,690 | 50,114,190 | 65,258,190 | 83,521,690 |
| Cost of IVR call/patient/year=cost of IVR only/n | 85.58 (1.38 USD) | 100.23 (1.61 USD) | 81.57 (1.31 USD) | 83.52 (1.34 USD) |
| Total cost of only the SMS reminder (national programme-level cost+number of centres×centre-level cost+n×patient-level cost for SMS reminder only) | 49,790,690 | 48,814,190 | 63,178,190 | 80,921,690 |
| Cost of the SMS reminder/person/year=cost of SMS reminder only/n | 82.98 (1.33 USD) | 97.63 (1.57 USD) | 78.97 (1.27 USD) | 80.92 (1.30 USD) |
Based on the existing 380 centres currently in existence and that one of the estimates by NACO indicates an expansion to 450 centres in 2017, we therefore assumed 450 ART centers for 500,000 patients in 2017;
http://lawmin.nic.in/coi/EIGHTH-SCHEDULE.pdf, the 23 languages include 22 Indian languages and English;
The actual number of patients on ART in December 2012 was 570,620, for the purpose of cost calculations this figure has been rounded up to 600,000 in 2012; 1 USD=61.95 INR as of 26 December 2013; The reference years for costing were 2012 and 2017.
Centre-level costs were multiplied by the number of ART centres (1) existing in 2012 and (2) expected in 2017. The number of ART centres used in the scale-up was based on the National AIDS Control Organisation estimates [7, 22]. NACO estimates that 450 ART centres are required for 800,000 patients and 600 ART centres are required for 1,000,000 patients.