Cost of pre-exposure prophylaxis delivery in family planning clinics to prevent HIV acquisition among adolescent girls and young women in Kisumu, Kenya Article Swipe
Valentine Wanga
,
Kathryn Peebles
,
Alfred Obiero
,
Felix Mogaka
,
Victor Omollo
,
Josephine Odoyo
,
Jennifer F. Morton
,
Elizabeth A. Bukusi
,
Connie Celum
,
Jared M. Baeten
,
Ruanne V. Barnabas
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1371/journal.pone.0249625
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1371/journal.pone.0249625
Introduction Oral pre-exposure prophylaxis (PrEP) is increasingly being implemented in sub-Saharan Africa. Adolescent girls and young women (AGYW) in Kenya contribute more than half of all new infections among young people aged 15–24 years, highlighting the need for evidence on the cost of PrEP in real-world implementation to inform the budget impact, cost-effectiveness, and financial sustainability of PrEP programs. Methods We estimated the cost of delivering PrEP to AGYW enrolled in a PrEP implementation study in two family planning clinics in Kisumu county, located in western Kenya. We derived total annual costs and the average cost per client-month of PrEP by input type (variable or fixed) and visit type (initiation or follow-up). We estimated all costs as implemented in the study, and under implementation by the Kenyan Ministry of Health (MoH), both at the program volume observed and if the facilities were delivering PrEP at full capacity (scaled-MoH). Results For the costing period between March 2018 and March 2019, 615 HIV-negative women contributed 1,128 (502 initiation and 626 follow-up) visits. The average cost per client-month of PrEP dispensed per study protocol and per the MoH scenario was $28.92 and $14.52, respectively. If the MoH scaled the program so that facilities could see PrEP clients at capacity, the average cost per client-month of PrEP was $10.88. Medication costs accounted for the largest proportion of the total annual costs (48% in MoH scenario and 65% in the scaled-MoH scenario). Conclusions Using data from a PrEP implementation program, we found that the cost per client-month of PrEP dispensed is reduced by 62% if PrEP delivery at the two clinics is scaled up by the MoH. Our findings are valuable for informing local resource allocation and budgetary cost projections for scale-up of PrEP delivery to AGYW. Additionally, previous cost-effectiveness studies have been limited by the use of fixed assumptions of the cost of PrEP per person-month. Our study provides cost estimates from practical data which will better inform cost-effectiveness and budget impact analyses.
Related Topics
Concepts
Kenya
Medicine
Pre-exposure prophylaxis
Activity-based costing
Christian ministry
Total cost
Cost effectiveness
Marginal cost
Average cost
Human immunodeficiency virus (HIV)
Environmental health
Family medicine
Demography
Business
Men who have sex with men
Accounting
Political science
Syphilis
Philosophy
Microeconomics
Economics
Risk analysis (engineering)
Sociology
Marketing
Neoclassical economics
Theology
Law
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1371/journal.pone.0249625
- https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249625&type=printable
- OA Status
- gold
- Cited By
- 18
- References
- 16
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3154226193
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W3154226193Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1371/journal.pone.0249625Digital Object Identifier
- Title
-
Cost of pre-exposure prophylaxis delivery in family planning clinics to prevent HIV acquisition among adolescent girls and young women in Kisumu, KenyaWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-04-15Full publication date if available
- Authors
-
Valentine Wanga, Kathryn Peebles, Alfred Obiero, Felix Mogaka, Victor Omollo, Josephine Odoyo, Jennifer F. Morton, Elizabeth A. Bukusi, Connie Celum, Jared M. Baeten, Ruanne V. BarnabasList of authors in order
- Landing page
-
https://doi.org/10.1371/journal.pone.0249625Publisher landing page
- PDF URL
-
https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249625&type=printableDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249625&type=printableDirect OA link when available
- Concepts
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Kenya, Medicine, Pre-exposure prophylaxis, Activity-based costing, Christian ministry, Total cost, Cost effectiveness, Marginal cost, Average cost, Human immunodeficiency virus (HIV), Environmental health, Family medicine, Demography, Business, Men who have sex with men, Accounting, Political science, Syphilis, Philosophy, Microeconomics, Economics, Risk analysis (engineering), Sociology, Marketing, Neoclassical economics, Theology, LawTop concepts (fields/topics) attached by OpenAlex
- Cited by
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18Total citation count in OpenAlex
- Citations by year (recent)
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2025: 8, 2024: 3, 2023: 5, 2022: 1, 2021: 1Per-year citation counts (last 5 years)
- References (count)
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16Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| publication_date | 2021-04-15 |
| publication_year | 2021 |
| referenced_works | https://openalex.org/W2607168371, https://openalex.org/W1976028120, https://openalex.org/W2205715013, https://openalex.org/W2964150391, https://openalex.org/W2995333784, https://openalex.org/W4294661837, https://openalex.org/W2789791939, https://openalex.org/W2943784055, https://openalex.org/W2884907577, https://openalex.org/W2790824153, https://openalex.org/W2805548493, https://openalex.org/W2808271684, https://openalex.org/W2910283074, https://openalex.org/W2787747421, https://openalex.org/W3010902133, https://openalex.org/W3189437243 |
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