Estimating the true costs of splitting HIV antiretroviral drugs
There is a temptation to switch to cheaper generic antiretroviral drugs compared to fixed-dose combination therapy for HIV patients in the interests of cost savings. However, in our analysis we found that there were no costs saved when including all patient care including drugs, additional clinic visits and monitoring. We also found that switching may cause confusion for some patients, risking loss of adherence. This evidence can help commissioners make better policy decisions about drug provision.
Understanding Idiopathic Pulmonary Fibrosis patient care delivery and costs
We explored patient pathways for the diagnosis, management and monitoring of idiopathic pulmonary fibrosis (IPF) across England, based on NICE pathways, and interviews with healthcare staff from 14 hospital trusts. Data were used in our in-house tool to estimate the cost of pathways, compared to tariff reimbursement. We found large variation across England in how services for IPF patients are delivered, variation compared to the NICE pathway, and costs >40% more than what is currently reimbursed.
Increased efficiency and improved treatment for stable HIV patients in England
Collaborators at St Georges Hospital wanted to understand the impact of changing service provision for stable HIV patients, as no evidence existed on what was best for clinics. We built a tool in Excel, and results indicated that 6-monthly appointments and 3-monthly home delivery of drugs is the cheapest option and could yield £2000 savings per patient, translating to an annual cost reduction of ~£8 million for the estimated 4000 eligible patients not currently on home delivery in England in 2012.
The true cost of treating invasive fungal infections in hospitals
We first created a generic framework to help decision-makers think about how to compare patient management whilst considering all costs to the healthcare provider. Then, we developed a specific tool for management of patients with invasive fungal disease (IFD). Lastly, we estimated that the attributable cost of managing adult haematology patients with IFD at Kings College Hospital (London) was more than £50,000 per case, with the inpatient stay cost far outstripping the cost of antifungal drugs.
The benefits and cost-savings of a new point-of-care test for chlamydia and gonorrhoea
We developed an understanding of how sexual health clinics in England could use a rapid point of care test for two common sexually transmitted infections. We defined the current patient care pathways and found that the pathways could be streamlined and costs of care reduced by using point-of-care tests. The economic model developed by Aquarius Population Health showed that the test could deliver £10 million in cost savings, and give far more effective management of chlamydia and gonorrhoea at a population level.
Benefits of a point of care test for sexual health testing
Managing Mycoplasma genitalium as an STI
The financial and service implications of splitting fixed-dose antiretroviral drugs – a case study
Point-of-care testing leads the way: article in the Parliamentary Review 2014
Mapping patient pathways and cost of point of care versus standard testing and treatment for chlamydia and gonorrhoea in sexual health clinics
