Navigation Links
Do the math, say UCLA researchers
Date:9/17/2010

In 2008, Reuben Granich and his colleagues at the World Health Organization published a paper in the medical journal The Lancet that proposed a new strategy for combating HIV in South Africa, a country staggered by the virus, with as much as 18 percent of the population estimated to be infected.

Based on a mathematical model, the study suggested a "test-and-treat" strategy. This would involve, among other steps, testing the entire population of South Africa for HIV and immediately beginning anti-retroviral therapy for all who tested positive. The current standard of care calls for waiting until symptoms appear after diagnosis.

Such a test-and treat strategy, the authors suggested, could eventually lead to the elimination of HIV in South Africa within a decade. Since then, the utility and feasibility of this approach have been widely debated, and it remains the leading potential prevention strategy for South Africa.

One aspect of the proposal that has not been examined, however, is the strategy's full estimated cost. Now, UCLA researchers have done their own modeling study and found that the costs have been substantially underestimated.

Reporting in the current online edition of The Lancet, Sally Blower, director of UCLA's Center for Biomedical Modeling and a member of the UCLA AIDS Institute, and Bradley Wagner, a postdoctoral scholar in Blower's lab, used their own sophisticated modeling techniques to duplicate the estimated cost curve used in the WHO report. They found that key potential costs including the expense of annual testing for a population of 32 million, the implementation of prevention programs and the "ramping up" of a health infrastructure that is currently overwhelmed were not included in the proposed approach.

Because the WHO did not disclose what costs they included in their estimates, Blower said, the UCLA researchers reconstructed it on their own. Using their own mathematical modeling, the researchers devised a cost curve based only on treatment costs.

The WHO report assumed that the maximum cost of treating a patient with first-line drugs would be $1,163 a year, and treatment with second-line drugs initiated when first-line therapy is no longer effective would be $4,083 a year. The WHO authors also assumed that 97 percent of patients would need first-line drugs and 3 percent would need second-line drugs each year.

Using this information, and the estimated 4.5 million individuals who would, once identified, need treatment annually, the UCLA researchers constructed a maximum cost curve that, for the first five years after implementation, exactly matched the cost estimated by the WHO.

And that is the problem, Blower said.

"Their cost curves are only based on treatment costs," she said. "They do not include the costs of an annual testing program for the 27 million adults in South Africa who are currently uninfected, nor do they include the costs of the extensive prevention interventions that are necessary to reduce transmission."

Most importantly, they also do not include any costs for the tenfold scaling up in the health care infrastructure that would be necessary to reach the entire population, Blower said.

"The health infrastructure in South Africa is at capacity now," Wagner said. "As a result, just reaching the entire population, many of whom live in remote rural areas in a country almost twice the size of Texas, would be hugely expensive and should be taken into account."

"Certainly, we should treat people who need it," Blower said. "But the costs of a universal test-and-treat strategy in South Africa have been substantially underestimated."


'/>"/>

Contact: Mark Wheeler
mwheeler@mednet.ucla.edu
310-794-2265
University of California -- Los Angeles
Source:Eurekalert

Related medicine news :

1. National Democratic Strategist Bob Weiner Discusses Healthcare, Political Aftermath, Obama Agenda in Radio Interview
2. Researchers map all the fragile sites of the yeast Saccharomyces cerevisiaes genome
3. UH Case Medical Center researchers publish promising findings for advanced cervical cancer
4. Researchers discover new way to kill pediatric brain tumors
5. Researchers Who Discovered First Genes for Stuttering will Present Findings to the National Stuttering Association
6. Researchers create drug to keep tumor growth switched off
7. Urine protein test might help diagnose kidney damage from lupus, UT Southwestern researchers find
8. GUMC researchers say flower power may reduce resistance to breast cancer drug tamoxifen
9. Clemson researchers develop hands-free texting application
10. Researchers find biomarkers in saliva for detection of early-stage pancreatic cancer
11. Researchers chart genomic map spanning over 2 dozen cancers
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/13/2016)... ... February 13, 2016 , ... In its newly released Infusion ... technology should be used to ensure patient safety when placing an IV catheter. ... mandate the use of vein visualization technology in patients with difficult venous access ...
(Date:2/12/2016)... , ... February 12, 2016 , ... According to an ... are beginning to account for a significant portion of hernia repairs throughout the United ... the Beverly Hills Hernia Center notes that this trend has not only been expected, ...
(Date:2/12/2016)... ... February 12, 2016 , ... CDRH Enforcement Trends: , Back to the Future , Feb. ... , As Winston Churchill said, “Those who don’t learn from history are doomed to repeat ... when they come knocking this year. But that takes time. , Take a close ...
(Date:2/12/2016)... ... 12, 2016 , ... T.E.N., a technology and information security ... Southeast Awards 2016. Finalists and winners of the ISE® Awards for both Executive ... Awards Gala on March 15, 2016 at the Westin Peachtree Plaza, Atlanta. ...
(Date:2/12/2016)... ... February 12, 2016 , ... AssureVest Insurance Group, a locally ... a charity drive that will raise funds earmarked to purchase computers and software for ... School. , “My school is in a low-income area and has more than 60 ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... - Cardiac Marker Diagnostic ... and Cancer Therapy. - European Point of Care ... - Key Diagnostic Testing Markets. - Molecular ... Genetic Testing. - Molecular Diagnostics in Infectious Disease ... Diagnostic Products World Markets. - Point of Care ...
(Date:2/11/2016)... 2016 PRO-DEX, INC. (NasdaqCM: PDEX) today announced financial ... 2015. The Company also filed its Quarterly Report on Form ... the Securities and Exchange Commission today. --> ... --> --> Net sales for ... or 95%, to $5.4 million from $2.8 million for the ...
(Date:2/11/2016)... OAKLAND, Calif. , Feb. 11, 2016  Walgreens ... stores across 39 states and Washington, D.C. ... in a move that was commended by shareholder advocacy organization ... President at As You Sow. "Many people hold on to ... options, which can have tragic consequences." --> ...
Breaking Medicine Technology: