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Cost-Effectivenss Study The cost implications of the Botswana National ARV Therapy Program are being evaluated under a 3-year N.I.H. study entitled “The Cost-Effectiveness of Highly Active Anti-retroviral Treatment for HIV and AIDS in Botswana.” The primary objectives of the Cost-effectiveness study are to (a) project the long-term financial, fixed capital and human resources required to sustain a large-scale national ARV program, (b) identify efficient models of care delivery, (c) distinguish cost-effective initial and subsequent drug regimens, and (d) examine the economic implications of alternative treatment eligibility criteria. The study will address key questions related to the costs and cost-effectiveness of implementing HAART at a national level in Botswana. The study will inform public sector resource allocation decisions regarding the widespread provision of anti-retroviral theirapy in Botswana from both societal and health care institutional perspectives. The main goals of Phase I, which was completed in 2004, were to predict the effectiveness of Botswana’s National ARV Program. To do this, a Markov process model was used to represent the course of HIV disease progression both with and without ARV therapy within a hypothetical population of 10,000 people in Botswana over a ten-year period. The model predicted that estimated program costs would total US$87.8 million. Model results also suggest that the program would almost double the average years lived from 4.36 years to 7.47 years. A full summary of the Phase I results will soon be submitted for publication in a manuscript entitled “The Costs and Cost-Effectiveness of Highly Active Antiretroviral Therapy in Botswana”. Phase II of the project will use collected localized data to correctly depict the reality of the HIV disease progression among Batswana. Moreover, as health service use was estimated from protocols of health centers, hospital guidelines and from a panel of health experts from Botswana in Phase I, Phase II will assess the impact on the Nation’s health care resources using real data. Health service utilization rates will be strengthened by using data obtained through random sampling of patient’s records and direct observation of medical personnel time spent with patients. |