title: Estimating age-based antiretroviral therapy costs for HIV-infected children in resource-limited settings based on World Health Organization weight-based dosing recommendations.
abstract: BACKGROUND
  Pediatric antiretroviral therapy (ART) has been shown to substantially reduce morbidity and mortality in HIV-infected infants and children. To accurately project program costs, analysts need accurate estimations of antiretroviral drug (ARV) costs for children. However, the costing of pediatric antiretroviral therapy is complicated by weight-based dosing recommendations which change as children grow.
  
  
  METHODS
  We developed a step-by-step methodology for estimating the cost of pediatric ARV regimens for children ages 0-13 years old. The costing approach incorporates weight-based dosing recommendations to provide estimated ARV doses throughout childhood development. Published unit drug costs are then used to calculate average monthly drug costs. We compared our derived monthly ARV costs to published estimates to assess the accuracy of our methodology.
  
  
  RESULTS
  The estimates of monthly ARV costs are provided for six commonly used first-line pediatric ARV regimens, considering three possible care scenarios. The costs derived in our analysis for children were fairly comparable to or slightly higher than available published ARV drug or regimen estimates.
  
  
  CONCLUSIONS
  The methodology described here can be used to provide an accurate estimation of pediatric ARV regimen costs for cost-effectiveness analysts to project the optimum packages of care for HIV-infected children, as well as for program administrators and budget analysts who wish to assess the feasibility of increasing pediatric ART availability in constrained budget environments.
authors.affiliation: Medical Practice Evaluation Center, Divisions of General Medicine, Massachusetts General Hospital, Boston, MA, USA. kdoherty6@partners.org.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Doherty
authors.forename: Shaffiq
authors.initials: S
authors.lastname: Essajee
authors.forename: Martina
authors.initials: M
authors.lastname: Penazzato
authors.forename: Charles
authors.initials: C
authors.lastname: Holmes
authors.forename: Stephen
authors.initials: S
authors.lastname: Resch
authors.forename: Andrea
authors.initials: A
authors.lastname: Ciaranello
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000191:economics*; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis / Q000379:methods; D016527:Drug Costs / Q000706:statistics & numerical data; D054796:Drug Dosage Calculations; D005260:Female; D017408:Guidelines as Topic; D015658:HIV Infections / Q000188:drug therapy*; D006295:Health Resources / Q000600:supply & distribution*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014944:World Health Organization
chemical_list: D019380:Anti-HIV Agents