@article{b998f02bf6f24409a24540b8cd9ae0f9,
title = "Estimating age-based antiretroviral therapy costs for HIV-infected children in resource-limited settings based on World Health Organization weight-based dosing recommendations",
abstract = "Background: Pediatric antiretroviral therapy (ART) has been shown to substantially reduce morbidity and mortality in HIV-infected infants and children. To accurately project program costs, analysts need accurate estimations of antiretroviral drug (ARV) costs for children. However, the costing of pediatric antiretroviral therapy is complicated by weight-based dosing recommendations which change as children grow. Methods. We developed a step-by-step methodology for estimating the cost of pediatric ARV regimens for children ages 0-13 years old. The costing approach incorporates weight-based dosing recommendations to provide estimated ARV doses throughout childhood development. Published unit drug costs are then used to calculate average monthly drug costs. We compared our derived monthly ARV costs to published estimates to assess the accuracy of our methodology. Results: The estimates of monthly ARV costs are provided for six commonly used first-line pediatric ARV regimens, considering three possible care scenarios. The costs derived in our analysis for children were fairly comparable to or slightly higher than available published ARV drug or regimen estimates. Conclusions: The methodology described here can be used to provide an accurate estimation of pediatric ARV regimen costs for cost-effectiveness analysts to project the optimum packages of care for HIV-infected children, as well as for program administrators and budget analysts who wish to assess the feasibility of increasing pediatric ART availability in constrained budget environments.",
keywords = "Antiretroviral therapy, Costs, Pediatric HIV",
author = "Kathleen Doherty and Shaffiq Essajee and Martina Penazzato and Charles Holmes and Stephen Resch and Andrea Ciaranello",
note = "Funding Information: The authors gratefully acknowledge the assistance of Andrew King and Zach Ward for calculations of weight-to-age distributions and of Dr. Lulu Muhe, World Health Organization, for comments on the analysis. We also thank the entire Cost-effectiveness of Preventing AIDS Complications (CEPAC)-International investigator team. This work was supported by the National Institutes of Health, including the National Institute of Allergy and Infectious Disease (NIAID: K01 AI078754 (ALC); R01 AI058736 (KD) and the IMPAACT network (NIAID and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) through a subaward from Johns Hopkins University: UM AI068632 (KD); and the World Health Organization (AC, MP, SE, KD). Overall support for IMPAACT was provided by the National Institute of Allergy and Infectious Diseases (NIAID) [U01 AI068632], the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the National Institute of Mental Health (NIMH) [AI068632]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This work was supported by the Statistical and Data Analysis Center at Harvard School of Public Health, under the National Institute of Allergy and Infectious Diseases cooperative agreement #5 U01 AI41110 with the Pediatric AIDS Clinical Trials Group (PACTG) and #1 U01 AI068616 with the IMPAACT Group. Support of the sites was provided by the National Institute of Allergy and Infectious Diseases (NIAID) and the NICHD International and Domestic Pediatric and Maternal HIV Clinical Trials Network funded by NICHD (contract number N01-DK-9-001/HHSN267200800001C).",
year = "2014",
month = may,
day = "2",
doi = "10.1186/1472-6963-14-201",
language = "English (US)",
volume = "14",
journal = "BMC health services research",
issn = "1472-6963",
publisher = "BioMed Central",
number = "1",
}