Telemed J E Health - Retrospective return on investment analysis of an electronic treatment adherence device piloted in the Northern Cape Province.

Tópicos

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Resumo

JECTIVE: The return on investment (ROI) for utilizing the SIMpill electronic treatment adherence solution as an adjunct to directly observed treatment short-course (DOTS) is assessed using data from a 2005 pilot of the SIMpill solution among new smear-positive tuberculosis (TB) patients in the Northern Cape Province. The value of this cost minimization analysis (CMA), for use by public health planners in low-resource settings as a precursor to more rigorous assessment, is discussed.MATERIALS AND METHODS: The retrospective analysis compares the costs and health outcomes of the DOTS-SIMpill cohort with DOTS-only controls. Hypothetical 5-year cash flows are generated and discounted to estimate net present values (NPVs).RESULTS: Comparison between the DOTS-SIMpill pilot cohort and DOTS-only supported controls, for a hypothetical implementation of 1,000 devices, over 5 years, demonstrates positive ROI for the DOTS-SIMpill cohort based on improved health outcomes and reduced average cost per patient. The net stream is shown to be positive from the first year. Discounted NPV is ZAR 3,255,256 (US$ 493,221) for a cohort that would have started mid 2005 and ZAR 3,747,636 (US$ 487,339) starting mid 2010. This is an ROI of 23% over the 5-year period.CONCLUSION: The addition of electronic treatment adherence support technology can help to improve TB outcomes and lower average cost per patient by reducing treatment failure and the associated higher cost and burden on limited resources. CMA is an appropriate initial analysis for health planners to highlight options that may justify more sophisticated methods such as cost effectiveness analysis or full cost benefit analysis where a preferred option is immediately revealed. CMA is proposed as a tool for use by public health planners in low-resource settings to evaluate the ROI of treatment adherence technology postpilot and prior to implementation.

Resumo Limpo

jectiv return invest roi util simpil electron treatment adher solut adjunct direct observ treatment shortcours dot assess use data pilot simpil solut among new smearposit tuberculosi tb patient northern cape provinc valu cost minim analysi cma use public health planner lowresourc set precursor rigor assess discussedmateri method retrospect analysi compar cost health outcom dotssimpil cohort dotson control hypothet year cash flow generat discount estim net present valu npvsresult comparison dotssimpil pilot cohort dotson support control hypothet implement devic year demonstr posit roi dotssimpil cohort base improv health outcom reduc averag cost per patient net stream shown posit first year discount npv zar us cohort start mid zar us start mid roi year periodconclus addit electron treatment adher support technolog can help improv tb outcom lower averag cost per patient reduc treatment failur associ higher cost burden limit resourc cma appropri initi analysi health planner highlight option may justifi sophist method cost effect analysi full cost benefit analysi prefer option immedi reveal cma propos tool use public health planner lowresourc set evalu roi treatment adher technolog postpilot prior implement

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