Evidence map›Paper›PMID 24100874›Full record

ReviewCurrent opinion in HIV and AIDS2013

Modeling the cost-effectiveness of HIV treatment: how to buy the most 'health' when resources are limited.

Jason Kessler, R Scott Braithwaite

Abstract readReview
In one paragraph

Review in Current opinion in HIV and AIDS, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Jason KesslerDivision of Comparative Effectiveness and Decision Science, Department of Population Health, New York University School of Medicine, New York, New York, USA.
R Scott Braithwaite

Funding

Implementation science to optimize HIV prevention in East Africa PEPFAR programs.R01AI099970 · NIAID · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BRAITHWAITE, RONALD SCOTT · 2012 to 2014
$2.7M
Consortium to improve Outcomes in HIV/AIDS, Alcohol, Aging & multi-Substance useU01AA020799 · NIAAA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BRAITHWAITE, RONALD SCOTT · 2011 to 2020
$2.1M
NIAAA NIH HHS U01 AA020799NIAAA NIH HHS U01AA020799NIAID NIH HHS R01 AI099970NIAID NIH HHS R01AI099970
6 · The paper itself

Abstract

purpose of reviewTo summarize recent cost-effectiveness analyses (CEAs) that evaluate optimal treatment strategies for persons living with HIV/AIDS (PLWHA). RECENT

findingsEfforts to attain universal coverage of current treatment guidelines (e.g., initiation at CD4 cell count <350 cells/μl) are generally very costeffective. Expansion of access beyond current guidelines will additionally improve clinical outcomes and aversion of new HIV infections; however, cost-effectiveness is more uncertain. Increasing access to antiretroviral therapy (ART) offers greater health benefit than investing the same funds in intensive laboratory monitoring for those on ART, particularly in those settings in which universal coverage has not yet been attained. Recommended ART regimens (e.g., tenofovir) have favorable cost-effectiveness when compared with substitution of newer, more expensive agents (e.g., rilpivirine, darunavir) or substitution of older, cheaper alternatives that are more toxic (e.g., stavudine). SUMMARY: There is increasing use of CEA to evaluate decisions regarding HIV treatment in order to buy the most 'health' with limited resources. Expansion of ART access provides substantial clinical and preventive benefit and offers favorable cost-effectiveness. Intensive laboratory monitoring may not be the highest priority in settings in which resources are constrained. Further work on the economic impact, clinical effectiveness, and feasibility of ART treatment for all (e.g., no CD4 cell initiation criteria) is needed.

Indexed as

Anti-Retroviral AgentsAntiretroviral Therapy, Highly ActiveCD4 Lymphocyte CountCost-Benefit AnalysisHealth ResourcesHIV InfectionsHumansViral LoadAnti-Retroviral Agents

Identifiers

PMID24100874
PMCPMC4084563

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.