Table 1 Parameter values used in the cost-effectiveness analysis of HIV treatment approaches in Mozambique

Epidemiology

 Number of people \(\ge\) 15 years old living with HIV

1,970,000 PLHIV

N/A

N/A

[47]

 Age distribution of PLHIV \(\ge\) 15 years old

15–19: 4.38%

20–24: 9.92%

25–29: 15.25%

30–34: 16.37%

35–39: 15.82%

40–44: 14.22%

45–49: 10.89%

50–54: 5.58%

55–59: 3.31%

60–64: 1.97%

65–69: 1.18%

70–74: 0.65%

75–80: 0.32%

 > 80: 0.15%

N/A

N/A

[47]

 Distribution between CD4 count stages at time of ART initiation

CD4 > 500 cells/µL: 31%

CD4 350–500 cells/µL: 19%

CD4 200–349 cells/µL: 23%

CD4 < 200 cells/µL: 27%

N/A

N/A

Internal INS data, 2022

 Mortality rates per 100 person-years for individuals with untreated HIV, by CD4 stage (with 95% CI)

CD4 > 500 cells/µL: 0.6

CD4 350–500 cells/µL: 1.6

CD4 200–349 cells/µL: 4.2

CD4 < 200 cells/µL: 21.2

CD4 > 500 cells/µL: 0.1–2.0

CD4 350–500 cells/µL: 0.8–3.0

CD4 200–349 cells/µL: 2.8–5.7

CD4 < 200 cells/µL: 13.2–41.5

PERT distributions

[48]

 CD4 count decrease per year without ART (range)

60 cells/µL

50–80 cells/µL

PERT distribution

[49]

 CD4 count decrease per year while on ART (inadequate adherence, viral resistance)

14 cells/µL

0–20 cells/µL

PERT distribution

[50, 51]

 CD4 count increase per year while on ART

205 cells/µL

170–250 cells/µL

PERT distribution

[52, 53]

 12-month LTFU risk for 1-month clinical ARV distribution

20%

12–32%

PERT distribution

[32, 35]

 LTFU rate for 3-month community ARV distribution

5.1 per 100 person-years

1.59–8.61 per 100 person-years

PERT distribution

[54]

 Adjusted odds ratio of LTFU in 2 years with multi-month ARV distribution (compared to 1-month clinical distributions)

3-month: 0.79

6-month: 0.41

3-month: 0.76–0.82

6-month: 0.31–0.54

PERT distributions

[55]

 Probability of reengaging in care 12 months after LTFU with/without patient tracing

With: 37.1%

Without: 15.1%

With: 30–44%

Without: 8–22%

PERT distribution

[56]

 Proportion of PLHIV on ART taking first-line ARVs

95%

75–98%

PERT distribution

[57, 58]

 Distribution of first-line ARV regimens by base-drug

Dolutegravir: 99%

Efavirenz: 1%

N/A

N/A

Internal CNCS data, 2021

 Risk of ART failing while on second-line ARVs

15 per 100 person-years

13–18 per 100 person-years

PERT distribution

[59]

 Annual risk of progressing to second-line ARVs by base-drug regimen

Dolutegravir: 0.25%

Efavirenz: 2.5%

Dolutegravir: 0–0.5%

Efavirenz: 2.0–3.3%

PERT distributions

[57]

[60, 61]

 Discount rate

5%

N/A

N/A

[43]

Health effects

 DALY weight for one year while on ART, by CD4 stage

CD4 > 500 cells/µL: 0.078

CD4 350–500 cells/µL: 0.1

CD4 200–349 cells/µL: 0.15

CD4 < 200 cells/µL: 0.2

N/A

N/A

[62]

 DALY weight for one year without ART, by CD4 stage

CD4 > 500 cells/µL: 0.012

CD4 350–500 cells/µL: 0.27

CD4 200–349 cells/µL: 0.377

CD4 < 200 cells/µL: 0.58

N/A

N/A

[62]

Costs (in 2020 US$ with adjustment for purchasing power parity in Mozambique for non-tradeable cost components)

 Currency conversion

US$1 = 73.37 meticais

1 metical = US$0.014

N/A

N/A

[63]

 Annual cost to the health sector per patient treated for clinical 1-month ARV distributions (excluding ARV costs)

$134

$104–163

PERT distribution

[33]

 Average annual cost to the health sector per patient treated by community 3-month ARV distributions (excluding ARV costs)

$160

$125–226

PERT distribution

[64]

 Per person cost of first-line ARV regimens per month

Dolutegravir: $5.55

Efavirenz: $6.40

N/A

N/A

[65]

 Per person cost of second-line ARV regimen per month

Ritonavir: $23.15

N/A

N/A

[65]

 Annual cost to the health sector for viral load testing (per patient)

$26

$20–43

PERT distribution

[33]

 Average monthly cost to the health sector for case management and patient support (per patient)

$37.97

$25–50

PERT distribution

[66, 67]

 Per-person cost to travel by minibus taxi (chapa)

20 meticais (US$0.28) per hour

$0.05-$1.00

PERT distribution

[68]

 Average round trip transit time to ART provision site (by chapa)

 < 60 min: 51%

60–240 min: 43%

 > 240 min: 6%

N/A

N/A

[69]

 Average round trip transit time to ART provision site (walking)

6 h

1–24 h

PERT distribution

[68, 70]

 Proportion of patients who travel by chapa to ART services

57.5%

33–66%

PERT distribution

[71, 72]

 Proportion of distance a patient travels to a mobile brigade ARV distribution site versus to a clinic

33%

15–50%

PERT distribution

Author estimation

 Average patient wait time for ART

1 h

0.25–4 h

PERT distribution

[73]

 OOP expenditure on health per capita in Mozambique

$4.14 per year

N/A

N/A

[39]

 Adjusted net national income per capita in Mozambique

$393 per year

N/A

N/A

[74]

 GDP per capita in Mozambique

$467 per year

N/A

N/A

[75]