Cost-effectiveness analysis of integrating screening and treatment of selected non-communicable diseases into HIV/AIDS treatment in Uganda

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dc.contributor.authorSando, David
dc.contributor.authorKintu, Alexander
dc.contributor.authorOkello, Samson
dc.contributor.authorKawungezi, Peter Chris
dc.contributor.authorGuwatudde, David
dc.contributor.authorMutungi, Gerald
dc.contributor.authorMuyindike, Winnie
dc.contributor.authorMenzies, Nicolas A.
dc.contributor.authorDanaei, Goodarz
dc.contributor.authorVerguet, Stephane
dc.date.accessioned2022-04-29T18:51:58Z
dc.date.available2022-04-29T18:51:58Z
dc.date.issued2020
dc.description.abstractDespite growing enthusiasm for integrating treatment of non-communicable diseases (NCDs) into human immunodeficiency virus (HIV) care and treatment services in sub-Saharan Africa, there is little evidence on the potential health and financial consequences of such integration. We aim to study the cost-effectiveness of basic NCD-HIV integration in a Ugandan setting. Methods: We developed an epidemiologic-cost model to analyze, from the provider perspective, the cost-effectiveness of integrating hypertension, diabetes mellitus (DM) and high cholesterol screening and treatment for people living with HIV (PLWH) receiving antiretroviral therapy (ART) in Uganda. We utilized cardiovascular disease (CVD) risk estimations drawing from the previously established Globorisk model and systematic reviews; HIV and NCD risk factor prevalence from the World Health Organization’s STEPwise approach to Surveillance survey and global databases; and cost data from national drug price lists, expert consultation and the literature. Averted CVD cases and corresponding disability-adjusted life years were estimated over 10 subsequent years along with incremental cost-effectiveness of the integration. Results: Integrating services for hypertension, DM, and high cholesterol among ART patients in Uganda was associated with a mean decrease of the 10-year risk of a CVD event: from 8.2 to 6.6% in older PLWH women (absolute risk reduction of 1.6%), and from 10.7 to 9.5% in older PLWH men (absolute risk reduction of 1.2%), respectively. Integration would yield estimated net costs between $1,400 and $3,250 per disability-adjusted life year averted among older ART patients. Conclusions: Providing services for hypertension, DM and high cholesterol for Ugandan ART patients would reduce the overall CVD risk among these patients; it would amount to about 2.4% of national HIV/AIDS expenditure, and would present a cost-effectiveness comparable to other standalone interventions to address NCDs in low- and middle-income country settings.en_US
dc.identifier.citationSando, D., Kintu, A., Okello, S., Kawungezi, P. C., Guwatudde, D., Mutungi, G., ... & Verguet, S. (2020). Cost‐effectiveness analysis of integrating screening and treatment of selected non‐communicable diseases into HIV/AIDS treatment in Uganda. Journal of the International AIDS Society, 23, e25507. https://doi.org/10.1002/jia2.25507en_US
dc.identifier.urihttps://doi.org/10.1002/jia2.25507
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/3006
dc.language.isoenen_US
dc.publisherJournal of the International AIDS Societyen_US
dc.subjectHIVen_US
dc.subjectAntiretroviral therapyen_US
dc.subjectNon-communicable diseasesen_US
dc.subjectHypertensionen_US
dc.subjectHypercholesterolaemiaen_US
dc.subjectDiabetesen_US
dc.subjectCardiovascular diseasesen_US
dc.subjectIntegrationen_US
dc.subjectSub-Saharan Africaen_US
dc.subjectUgandaen_US
dc.titleCost-effectiveness analysis of integrating screening and treatment of selected non-communicable diseases into HIV/AIDS treatment in Ugandaen_US
dc.typeArticleen_US
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