Sarah Gutkind, MPH
Pre-doctoral fellow in the Substance Abuse Epidemiology Training Program at Columbia University Mailman School of Public Health.
In this study, Gutkind and colleagues found that the cost per participant decreases with higher caseloads in real-world settings compared to costs incurred in the intervention trial. In a sensitivity analysis, maintaining a site’s peak caseload during the trial (approximately 5 participants per week on average) was found to lower the cost per participant by a half, from $450 to $220 in 2017 USD. When adapting to a real-world setting with a maximum of 10 cases per week, the cost each week per participant lowered by three quarters, from $450 to $110 in 2017 USD. Co-authors also found the average start-up cost for HCV care facilitation to be approximately $6,320 per trial site. Costs could be further reduced by adapting administrative and recruitment processes for real-world settings, such as maximizing outreach activities through site visitations and database search records, reducing the number of supervision meetings, and leveraging local staff and webinars to conduct start-up trainings.
The weekly cost of hepatitis C virus infection (HCV) care facilitation was estimated to be $450 per HIV and HCV co-infected individual recruited from a clinical trial. In real-world settings with higher caseloads, the cost would decrease to approximately $110 per person.