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. Author manuscript; available in PMC: 2019 May 21.
Published in final edited form as: J Manag Care Spec Pharm. 2018 Feb;24(2):165–172. doi: 10.18553/jmcp.2018.24.2.165

TABLE 3.

Results of Adherence Intervention Net Cost Sensitivity and Scenario Analyses

Change from Base-Case Value, %a Cost of Adherence Intervention, $ HIV Infections Averted Treatment Cost Savings, $ Treatment Savings/ Intervention Cost
Base-case results – 16,811 0.134 49,702 2.96
Pharmacist compensation
 $64.11 per hourb −23.20 13,643 0.134 49,702 3.64
 $104.77 per hourb +25.10 20,191 0.134 49,702 2.46
Receptionist compensation
 $13.01 per hourc −30.20 16,693 0.134 49,702 2.98
 $27.13 per hourc +45.50 16,988 0.134 49,702 2.93
Clinic overhead rate
 15% −40.00 15,863 0.134 49,702 3.13
 35% +40.00 18,112 0.134 49,702 2.74
Value of patients’ time
 $0 −100.00 15,341 0.134 49,702 3.13
 $33.19/hourd +343.00 21,847 0.134 49,702 2.74
Patients’ round-trip travel costs
 $7.72e −51.80 15,983 0.134 49,702 3.15
 $24.74e +54.50 18,112 0.134 49,702 2.69
Reduction in HIV transmission rate for patients with undetectable virus
 96%f +6.67 16,811 0.134 49,791 2.96
 84%f −6.67 16,811 0.123 45,570 2.71
Lifetime HIV treatment costs
 $373,916g +0.63 16,811 0.134 50,015 3.27
 $368,510g −0.83 16,811 0.134 49,292 2.93
Most favorable combinationh – 10,376 0.123 45,194 5.06
Least favorable combinationh – 29,457 0.145 54,352 1.53
a

Base-case parameter values: pharmacist compensation=$83.78/hour (includes inflation-adjusted median hourly wage for pharmacists of $58.22,33 plus benefits calculated at the average fringe benefit rate34); 43.9% is the average fringe benefit rate for health care and social assistance workers in the United States34; receptionist compensation=$18.65/hour (includes inflation-adjusted median hourly wage for receptionists of $12.96, plus benefits35); clinic overhead rate= 25%; value of patients’ time =$7.50/hour36; median round-trip travel cost (includes mileage cost and patient’s time cost) =$16.01, which corresponds to an 18-mile, 45-minute trip; annual HIV transmission rate without antiretroviral therapy= 0.03716; HIV transmission rate reduction for patients with undetectable viral load= 90%; adnd HIV-related treatment costs averted by preventing an HIV infection =$371,578.26

b

Inflation-adjusted 10th and 90th percentile hourly wages for pharmacists in the United States,33 plus U.S. average fringe benefit rate.34

c

Inflation-adjusted 10th and 90th percentile hourly wages for receptionists in the United States,35 plus U.S. average fringe benefit rate.34

d

Median hourly compensation (wage plus fringe benefits) for civilian workers in the United States.34

e

25th and 75th percentile round-trip travel costs for study participants who completed the intervention.

f

The upper bound estimate (96%) is the reduction in the likelihood of HIV transmission for patients on ART with suppressed (undetectable) virus in the HTPN 052 study3; the lower bound estimate (84%) was selected so that the base-case estimate (90%) was the mean of the lower and upper bounds.

g

5th and 95th percentile estimates of HIV-related treatment costs averted by preventing an HIV infection.26

h

The combination of parameters that is the most favorable to the intervention consists of the top parameter of each parameter pair.

ART= antiretroviral therapy; HIV= human immunodeficiency virus.