Effectiveness and Cost Effectiveness of Expanding Harm Reduction and Antiretroviral Therapy in Ukraine
Author Information
Author(s): Sabina S. Alistar, Douglas K. Owens, Margaret L. Brandeau, David D. Celentano
Primary Institution: Stanford University
Hypothesis
What is the effectiveness and cost-effectiveness of strategies for expanding methadone substitution therapy and antiretroviral therapy in Ukraine's mixed HIV epidemic?
Conclusion
Methadone substitution therapy is a highly cost-effective option for the growing mixed HIV epidemic in Ukraine.
Supporting Evidence
- Offering methadone substitution therapy to 25% of IDUs reduced HIV prevalence most effectively.
- Expanding both ART and methadone substitution therapy was the next most cost-effective strategy.
- Expanding only ART added fewer QALYs and averted fewer infections compared to methadone substitution therapy.
Takeaway
This study shows that giving more people access to methadone treatment can help reduce HIV infections and is a smart use of money.
Methodology
A dynamic compartmental model of the HIV epidemic was developed, considering various intervention strategies and measuring health care costs, quality-adjusted life years (QALYs), and infections averted.
Limitations
The study assumes homogeneous mixing between individuals and relies on limited data about the effectiveness of methadone substitution therapy in Ukraine.
Participant Demographics
The model considered a population of 1,000,000 individuals aged 15-49, with a focus on injection drug users (IDUs) and non-IDUs.
Statistical Information
Confidence Interval
US$250–US$930/QALY gained
Digital Object Identifier (DOI)
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