Table 5.
Intervention cost per outcome
| Publication | Continuum of care costed | Total implementation cost | Cost per client | ||
|---|---|---|---|---|---|
| Intervention | Control | Intervention | Control | ||
| HIVST | |||||
|
Choko et al. 2019 [97] Intervention: HIVSTa Control: SOC |
Testing and initiated ART treatment |
Total intervention cost (excluding ART or VMMC): 1. STb = USD 3446.03 2. ST + $3 = USD 3678.44 3. ST + $10 = USD 7469.87 4. ST + lottery = USD 1175.64 5. ST + phone = USD 3 464.41 |
SOC = USD 557.40 |
1. Cost per male partner tested + attended male friendly clinics (MFC): a. ST = USD 40.54 b. ST + $3 = USD 23.73 c. ST + $10 = USD 28.08 d. ST + lottery = USD 39.19 e. ST + phone = USD 41.24 2. Cost per male partner tested + ARTc/VMMCd: a. ST = USD 127.63 b. ST + $3 = USD 94.32 c. ST + $10 = USD 109.85 d. ST + lottery = USD 167.95 e. ST + phone = USD 157.47 |
1. Cost per male partner tested + attended MFCe: SOCf = USD 9.95 2. Cost per male partner tested + ART/VMMC: SOC = USD 39.81 |
|
George et al. 2018 [98] Intervention: HIVST Controls: SOC and Enhanced SOC |
Testing |
Total intervention cost • Trucker = USD 3678.44 • FSWg = USD 7469.87 1. Total cost per intervention (Trucker): a. HIVST = USD 544.03 2. Total cost per intervention (FSW): • HIVST = USD 925.55 |
1. Total intervention cost • SOC = USD 284.81 • Enhanced SOC = USD 335.69 2. Total cost per intervention (FSW): • SOC = USD 411.18 • Enhanced SOC = USD 473.04 |
1. Cost per client (Trucker): • HIVST = USD 20.92 2. Cost per client (FSW): • HIVST = USD 11.43 3. Cost per additional client tested (Trucker): • HIVST = USD 21.48 4. Cost per additional client tested (FSW): • HIVST = USD 15.80 |
1. Cost per client (Trucker): • SOC = USD 28.48 • Enhanced SOC = USD 33.57 2. Cost per client (FSW): • SOC = USD 9.56 • Enhanced SOC = USD 10.28 3. Cost per additional client tested (Trucker): • SOC = USD 26.26 • Enhanced SOC = USD 30.80 4. Cost per additional client tested (FSW): • SOC = USD 9.90 • Enhanced SOC = USD 10.63 |
|
Maheswaran et al. 2016 [99] Intervention: HIVST Control: FBHTCh |
Testing, HIV diagnosis, and ART initiation | Total annual health provider cost: HIVST = USD 133 300 |
• Ndirande = USD 50 899 • Chilomani = USD 56 760 • QECHl = USD 84 436 |
1. Direct cost per individual tested: HIVST = USD 8.78 2. Direct cost per HIV positive identified: HIVST = USD 97.50 3. Direct cost per HIV positive individuals assessed for ART eligibility: HIVT Service = USD 165.14 4. Direct cost per HIV positive individuals initiated onto ART: • HIVST = USD 319.67 |
1. Direct cost per individual tested: • Ndirande = USD 7.53 • Chilomani = USD 10.57 • QECH = USD 8.90 2. Direct cost per HIV positive identified: • Ndirande = USD 67.33 • Chilomani = USD 76.39 • QECH = USD 28.30 3. Direct cost per HIV positive individuals assessed for ART eligibility: • Ndirande = USD 83.48 • Chilomani = USD 92.38 • QECH = USD 37.73 4. Direct cost per HIV positive individuals initiated onto ART: • Ndirande = USD 109.85 • Chilomani = USD 132.42 QECH = USD 85.75 |
| Home-based HIV counseling and testing | |||||
|
Bogart et al. 2017 [95] Intervention: HBHTCj Control: EBHTCk |
Testing | HBHTC = USD 62 247 | EBHTC = USD 25 780 | HBHTC = USD 45.09 | EBHTC = USD 46.99 |
|
Cham et al. 20191 [96] Intervention: HBHTC Controls: PITCl and VBHTCm |
Testing and HIV diagnosis |
1. Total intervention cost = USD 720 607.67 2. Total cost per intervention: HBHTC = USD 176 865.66 |
1. Cost per intervention • PITC = USD 404 364.89 • VBHTC = USD 139 377.12 |
1. Cost per test: HBHTC = USD 6.45 2. Cost per new HIV diagnosed: HBHTC = USD 354.44 |
1. Cost per test: • PITC = USD 4.55 • VBHTC = USD 7.98 2. Cost per new HIV diagnosed: • PITC = USD 123.66 • VBHTC = USD 372.67 |
|
Mulogo et al., 20132 [101] Intervention: HBHTC Control: FBHTC |
Testing and HIV diagnosis. | USD 3114 | USD 2462 |
1. Cost per client tested: USD 5.0 2. Average cost per client diagnosed HIV positive: USD 1 |
1. Cost per client tested: USD 6.4 2. Average cost per client diagnosed HIV positive: USD 2 |
|
Tabana et al. 20153 [104] Intervention: HBHTC Control: FBHTC |
Testing | USD 233 239.02 | USD 146 615.12 | USD 29 | USD 38 |
| Mobile HIV Counseling and Testing | |||||
|
Meehan et al. 2017 [100] Intervention: MHTCn Control: SAHTSo |
Testing, HIV diagnosis, referral to treatment. | USD 77 764 | USD 96 616 |
1. Cost per person counseled: USD 25 2. Cost per person test: USD 25 3. Cost per HIV diagnosed: USD 1051 4. Cost per HIV referred: USD 1065 5. Cost per linked to HIV care: USD 2102 |
1. Cost per person counseled: USD 50 2. Cost per person test: USD 51 3. Cost per HIV diagnosed: USD 755 4. Cost per HIV referred: USD 773 5. Cost per linked to HIV care: USD 1039 |
|
Parker et al. 2015 [103] Intervention: MHTC Control: HBHTC |
Testing and HIV diagnosis. |
1. Cost per person reached: USD 24 2. Cost per HIV positive identified: USD 543 3. Cost per HIV positive identified and linked to care: USD 1698 |
4. Cost per person reached: USD 11 5. Cost per HIV positive identified: USD 343 6. Cost per HIV positive identified and linked to care: USD 797 |
||
| Provider-initiated counseling and testing | |||||
|
Obure et al. 2012 [102] Intervention: PITC Control: VCTp |
Testing and HIV diagnosis. |
Average annual economic cost 1. Kenya: USD 3 721 2. Swaziland: USD 10 407 |
Average annual economic cost 1. Kenya: USD 11 969 2. Swaziland: USD 16 716 |
1. Average cost per client: • Kenya: USD 5.71 • Swaziland: USD 7.79 2. Average cost per client diagnosed HIV positive: • Kenya: USD 46.96 • Swaziland: USD 47.85 |
1. Average cost per client: • Kenya: USD 8.27 • Swaziland: USD 9.44 2. Average cost per client diagnosed HIV positive: • Kenya: USD 110.32 • Swaziland: USD 45.56 |
Estimated incremental cost over 2.5 years;
2ICER = 3.50
3ICER = 19
aHIVST: HIV self-testing
bST standard of care + access to HIVST
cART antiretroviral therapy
dVMMC voluntary medical male circumcision
eMFC male friendly clinics
fSOC standard of care
gFSW female sex workers
hFBHTC facility-based HIV testing and counseling
iQECH Queen Elizabeth Central Hospital
jHBHTC home-based HIV testing and counseling
kEBHTC event-based HIV testing and counseling
lPITC provider-initiated testing and counseling
mVBHTC venue-based HIV testing and counseling
nMHTC mobile-based HIV testing and counseling
oSAHTS stand-alone community-based HIV testing and counseling
pVCT voluntary counseling and testing