The cost of antiretroviral therapy in Haiti

Table 2 Direct treatment utilization and costs for patients that remained in care for one full year (n = 169)

	Mean utilization per patient for the 1^st year of ART	Median utilization (IQ range) per patient for the 1^st year of ART	Mean cost per patient for the 1^st year of ART ($US)	Median cost (IQ range) per patient for the 1^st year of ART ($US)
Pre-ART workup (labor and laboratory studies)	*	*	58	61 (61 to 61)
Labor cost (# of ART visits)	14.9	15 (14 to 16)	59	54 (47 to 63)
CD4 cell counts** (# of tests)	1.3	1 (1 to 2)	39	30 (30 to 60)
ART monitoring labs (# of tests)	11.3	11 (9 to 13)	85	85 (68 to 99)
TB tests (# of tests)	1.8	0 (0 to 3)	8	0 (0 to 14)
Other laboratory tests (# of tests)	3.2	2 (1 to 4)	9	8 (2 to 13)
Chest radiographs (# of x-rays)	0.4	0 (0 to 1)	10	0 (0 to 24)
Anti-retroviral therapy (# of days on ART)	357	367 (355 to 379)	439	413 (273 to 601)
TB medications (# of days on therapy)	21	0 (0 to 0)	6	0 (0 to 0)
Other medications***	*	*	37	31 (21 to 42)
Outside referrals	0.4	0 (0 to 0)	39	0 (0 to 19)
Hospitalizations	0.05	0 (0 to 0)	35	0 (0 to 0)
Telephone cards	2.4	3.2 (2 to 3)	3	4 (3 to 4)
Nutritional support	*	*	145	160 (100 to 200)
Total (# of days in care)	364	365 (365 to 365)	972	923 (770 to 1098)

IQ range = interquartile range
* No utilization units defined.
** This does not include the baseline CD4 cell count done before the initiation of ART; also, many patients had a 12-month CD4 cell count that was done more than 365 days after ART initiation, and was therefore excluded from the analysis.
*** GHESKIO paid a mean cost of US$33.69 per patient for other medications (i.e. not including ART or TB drugs). The mean cost per patient for medications purchased outside of GHESKIO was $US 4.31 (median cost of $US 1.23).

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