{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:25:27Z","timestamp":1783117527943,"version":"3.54.6"},"reference-count":56,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In the current era of universal antiretroviral treatment (ART), health systems have the dual challenge of a growing number of people living with HIV and on ART who are also receiving chronic, life\u2010long treatment for non\u2010communicable diseases. Current evidence suggests that 6\u2010month multi\u2010month dispensing (6MMD) can maintain at least equivalent clinical outcomes to conventional care and reduce costs, but little is known when integrating 6MMD for multiple conditions. We examined the cost\u2010effectiveness of integrated multi\u2010month drug dispensing for people living with HIV and hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using an age\u2010 and sex\u2010specific hybrid decision tree and Markov state\u2010transition model, we constructed a 100,000\u2010person simulated population cohort who may develop HIV and hypertension and initiate treatment at clinics in South Africa over a 10\u2010year time horizon. We assessed the incremental costs and effectiveness of 6MMD versus conventional care from a health system perspective under different conditions of care\u2010seeking, eligibility and uptake of 6MMD for clinically stable patients. Model inputs were sourced from previously published literature. 6MMD was defined as reducing the frequency of clinic visits by increasing the number of medications dispensed to stable patients at each visit from 3 to 6 months. For the integrated 6MMD, we assumed that comorbid patients receive both HIV and hypertension drugs at the same facility on the same day.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our study demonstrates that integrated 6MMD for HIV and hypertension in South Africa can avert between 0.8 and 1 DALYs and increase health systems costs between $24 and $49 per patient per year, compared to the status quo. One\u2010way sensitivity analysis showed that HTN drug cost and prevalence of HIVHTN and HIV were key drivers in the cost per DALYs averted. Overall, integrated 6MMD with a greater proportion of well\u2010controlled patients and lower mortality rates led to greater cost savings or better cost\u2010effectiveness (less than $50 per DALY averted) across a wide range of loss\u2010to\u2010follow\u2010up (LTFU) factor variation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>By better controlling disease among patients already in care, integrated 6MMD can be more beneficial than the status quo treatment by resulting in fewer cases of LTFU and fewer deaths through high\u2010quality care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26413","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T23:20:26Z","timestamp":1739402426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Integrated multi\u2010month dispensing for HIV and hypertension in South Africa: A model of epidemiological impact and cost\u2010effectiveness"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1440-2786","authenticated-orcid":false,"given":"Youngji","family":"Jo","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences School of Medicine University of Connecticut  Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-2964","authenticated-orcid":false,"given":"Sydney","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Global Health Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-4999","authenticated-orcid":false,"given":"Brooke E.","family":"Nichols","sequence":"additional","affiliation":[{"name":"Department of Global Health Boston University School of Public Health  Boston Massachusetts USA"},{"name":"Department of Medical Microbiology Amsterdam University Medical Center  Amsterdam the Netherlands"},{"name":"Health Economics and Epidemiology Research Office, Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2354-4580","authenticated-orcid":false,"given":"Lise","family":"Jamieson","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office, Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"},{"name":"The South African Department of Science and Innovation\/National Research Foundation Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) Stellenbosch University  Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkgomeleng","family":"Lekodeba","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office, Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Robert","family":"Horsburgh","sequence":"additional","affiliation":[{"name":"Department of Global Health Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25525"},{"key":"e_1_2_12_3_1","unstructured":"South Africa Human Science Research Council (HSRC).The Sixth South African National HIV Prevalence Incidence and Behavior Survey (SABSSM VI). 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