The Price of Nonabandonment: HIV in Resource-Limited Settings

Amin Khademi (), Denis R. Saure (), Andrew J. Schaefer (), Ronald S. Braithwaite () and Mark S. Roberts ()
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Amin Khademi: Clemson University, Clemson, South Carolina 29634
Denis R. Saure: University of Chile, Santiago, Chile
Andrew J. Schaefer: University of Pittsburgh, Pittsburgh, Pennsylvania 15260
Ronald S. Braithwaite: New York University, New York, New York 10003
Mark S. Roberts: University of Pittsburgh, Pittsburgh, Pennsylvania 15260

Manufacturing & Service Operations Management, 2015, vol. 17, issue 4, 554-570

Abstract: The global fight against HIV/AIDS is hindered by a lack of drugs in the developing world. When patients in these countries initiate treatment, they typically remain on it until death; thus, policy makers and physicians follow nonabandonment policies. However, treated patients develop resistance to treatment, so in many cases untreated patients might benefit more from the drugs. In this paper we quantify the opportunity cost associated with restricting attention to nonabandonment policies. For this, we use an approximate dynamic programming framework to bound the benefit from allowing premature treatment termination. Our results indicate that in sub-Saharan Africa, the price associated with restricting attention to nonabandonment policies lies between 4.4% and 8.1% of the total treatment benefit. We also derive superior treatment allocation policies, which shed light on the role behavior and health progression play in prioritizing treatment initiation and termination.

Keywords: HIV; resistance; nonabandonment allocation policy; approximate dynamic programming (search for similar items in EconPapers)
Date: 2015
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Citations: View citations in EconPapers (11)

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Persistent link: https://EconPapers.repec.org/RePEc:inm:ormsom:v:17:y:2015:i:4:p:554-570

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