Fig 1.
Assumptions for number of visits and allocation of resource costs for treatment of pre-cancerous lesions and cervical cancer under non-integrated and integrated scenarios.
aNumber of visits refers to the assumed number of times a patient would travel to the clinic for treatment of pre-cancerous lesions under the non-integrated scenario. bResource costs allocation strategy refers to the method used to allocate costs of shared resources under each scenario. Shared resources included overhead and capital costs, as well as costs of multi-use supplies (i.e., supplies used for both the treatment of pre-cancerous lesions and other non-related services at the HIV-treatment facility). cNumber of additional visits beyond HIV-treatment visits refers to the number of times a patient would travel to the clinic for treatment of pre-cancerous lesions under the semi-integrated and fully-integrated scenarios. Zero additional visits for treatment and results assumes that the woman would receive services related to pre-cancerous lesions on the same day as their HIV-treatment visit, creating efficiencies associated with the integration of services. In the semi-integrated scenario, it was assumed that the first pre-cancer visit would be conducted on the same day as an HIV-treatment visit, but any subsequent visits would take place at visits separate from their next HIV-treatment visit. In the fully integrated scenario, it was assumed that all pre-cancer visits would be conducted on the same day as an HIV-treatment visit, leveraging the fact that many women attend HIV-treatment centers at regular intervals for medications and HIV-related care. Additional costing assumptions are provided in Table 1.
Table 1.
Base case assumptions and calculation methods for societal-level cost estimation.
Table 2.
Characteristics of patients attending CHC and KNH for treatment of pre-cancerous lesions and cervical cancer (N = 54) †.
Fig 2.
Comparison of integrated vs. non-integrated costs of treatment for pre-cancerous lesions by care component.
Table 3.
Non-integrated and integrated costs to society for treatment of pre-cancerous lesions integrated into HIV-Care (2017 USD).
Table 4.
Estimated costs to society of treatment of cervical cancer in Nairobi Kenya (2017 USD)*.