Cost of Hepatitis C care facilitation for HIV/Hepatitis C Co-infected people who use drugs.

Abstract

BACKGROUND:

Using data from a randomized trial, we evaluated the cost of HCV care facilitation that supports moving along the continuum of care for HIV/HCV co-infected individuals with substance use disorder.

METHODS:

Participants were HIV patients residing in the community, initially recruited from eight US hospital sites. They received HCV care facilitation (n = 51) or treatment as usual (n = 62) for up to six months. We used micro-costing methods to evaluate costs from the healthcare sector and patient perspectives in 2017 USD. We conducted sensitivity analyses varying care facilitator caseloads and examined offsetting savings using participant self-reported healthcare utilization.

RESULTS:

The average site start-up cost was $6320 (site range: $4320-$7000), primarily consisting of training. The mean weekly cost per participant was $20 (site range: $4-$30) for care facilitation visits and contacts, $360 (site range: $130- $700) for supervision and client outreach, and $70 (site range: $20-$180) for overhead. In sensitivity analyses applying a weekly caseload of 10 participants per care facilitator (versus 1-6 observed in the trial), the total mean weekly care facilitation cost from the healthcare sector perspective decreased to $110. Weekly participant time and travel costs averaged $7. There were no significant differences in other healthcare service costs between participants in the intervention and control arms.

CONCLUSION:

Weekly HCV care facilitation costs were approximately $450 per participant, but approximately $110 at a real-world setting maximum caseload of 10 participants per week. No healthcare cost offsets were identified during the trial period, although future savings might result from successful HCV treatment.

• Authors: Sarah Gutkind, Laura E Starbird, Sean M Murphy, Paul A Teixeira, Lauren K Gooden, Tim Matheson, Daniel J Feaster, Mamta K Jain, Carmen L Masson, David C Perlman, Carlos Del Rio, Lisa R Metsch, Bruce R Schackman
• Journal: Drug and alcohol dependence (Drug Alcohol Depend) Vol. 232 Pg. 109265 (03 01 2022) ISSN: 1879-0046 [Electronic] Ireland
• PMID: 35042101 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2022 Elsevier B.V. All rights reserved.

Topics

• Coinfection
• Cost-Benefit Analysis
• HIV Infections (therapy)
• Health Care Costs
• Hepacivirus
• Hepatitis C (drug therapy, therapy)
• Humans