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LEISEGANG, R., CLEARY, S., HISLOP, M., DAVIDSE, A., REGENSBERG, L., LITTLE, F. & MAARTENS, G. (2009) Early and late direct costs in a Southern African antiretroviral treatment programme: A retrospective cohort analysis. PLOS Medicine, 6(12)

Published; 1 Decemer 2009

Background
There is a paucity of data on the health care costs of antiretroviral therapy (ART) programmes in Africa. Our objectives were to describe the direct heath care costs and establish the cost drivers over time in an HIV managed care programme in Southern Africa.

Conclusions
Drivers of mean total costs changed considerably over time. Starting ART at higher CD4 counts or longer pre-ART care should reduce early costs. Monitoring ART adherence and interventions to improve it should reduce later costs. Cost models of ART should take into account these time-dependent cost drivers, and include costs before starting ART.