Table 2: Economic results from included studies.
Costs are reported from the provider’s perspective. USD = United States Dollar; ARV = antiretroviral drug; ART = antiretroviral therapy; DART = differentiated ART delivery model; ISPA = indirectly-supervised pharmacist assistant. *Negative values indicate DART model costs less than comparator. Positive values indicate DART model costs more than comparator.
| Author (Pub Year) |
Model Description |
Country | USD Year | Annual DART cost per patient (Nominal USD) |
Annual DART cost per patient, excluding ARVs (2018 USD) |
Annual incremental cost per patient (DART - Comparator) (2018 USD)* |
Drivers of incremental cost |
|---|---|---|---|---|---|---|---|
| FACILITY-BASED INDIVIDUAL | |||||||
| Babigumira (2011)16 | Task shifting | Uganda | 2009 | $496 | $294 | −$132 | Personnel |
| Barton (2013)17 | Task shifting | South Africa | 2009 | $400 (Cohort 1); $481 (Cohort 2) | $326 (Cohort 1); $233 (Cohort 2) | $101 (Cohort 1); $69 (Cohort 2) | Personnel, visit length and frequency, start up, supervision |
| Foster (2012)22 | Task shifting | South Africa | 2010 | NA | ISPA: $71 Nurse-driven: $114 | ISPA vs. pharmacist: $12 Nurse-driven vs. pharmacist: $56 | Number of visits, personnel |
| Jain (2015)18 | Task shifting | Uganda | 2012 | $987 (baseline), $628 (steady state) | $889 (baseline), $494 (steady state) | NA | Personnel, lab testing |
| Johns (2014)20 | Task shifting | Ethiopia | 2011 | $216 | $106 | $8 | Reduced personnel costs offset by higher costs for training, supervision, and drugs |
| Johns (2016)19 | Down-referral and task shifting | Nigeria | 2011 | $265 (Site 1); $324 (Site 2) | $165 (Site 1), $247 (Site 2) | $62 (Site 1), -$166 (Site 2) | Personnel |
| Long (2011)21 | Down-referral and task shifting | South Africa | 2009 | $486 | $260 | −$91 | Personnel, lab tests, fixed costs |
| Prust (2017)23 | Multi-month scripting | Malawi | 2016 | $121 | $28 | −$15 | Personnel |
| Prust (2017)23 | Fast-track refills | Malawi | 2016 | $121 | $27 | −$15 | Personnel |
| Shade (2017)24 | Multi-month scripting | Uganda, Kenya | 2016 | $270 (Uganda), $309 (Kenya) | $166 (Uganda); $178 (Kenya) | NA | NA |
| Vu (2016)15 | Task shifting (Uganda Cares) | Uganda | 2009 | $257 | $76 | NA | NA |
| COMMUNITY-BASED INDIVIDUAL | |||||||
| Jaffar (2009)25 | Home-based delivery | Uganda | 2008 | $793 | $438 | −$51 | Personnel |
| Vu (2016)15 | Community distribution points (TASO) | Uganda | 2012 | $322 | $201 | NA | NA |
| Vu (2016)15 | Community-based delivery (Kitovu Mobile) | Uganda | 2012 | $404 | $258 | NA | NA |
| FACILITY-BASED GROUP | |||||||
| Bango (2016)30 | Adherence clubs | South Africa | 2011 | $300 | $178 | −$83 | Personnel |
| COMMUNITY-BASED GROUP | |||||||
| Prust (2017)23 | Community ART groups | Malawi | 2016 | $122 | $29 | −$14 | Personnel |