Journal
MEDICAL CARE
Volume 44, Issue 11, Pages 990-997Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.mlr.0000228021.89490.2a
Keywords
HIV; AIDS; cost; life expectancy; computer simulation model
Categories
Funding
- NIAID NIH HHS [R01 AI042006, K23 AI001794, K24 AI062476, K25 AI050436, R01 AI42006, P30 AI042851, P30 AI42851, K23 AI01794, K25 AI50436] Funding Source: Medline
- NIDA NIH HHS [K23 DA00523, K01 DA17179, K01 DA017179, K23 DA000523] Funding Source: Medline
- PHS HHS [290-01-0012] Funding Source: Medline
Ask authors/readers for more resources
Objective: We sought to project the lifetime cost of medical care for human immunodefiency virus (HIV)-infected adults using current antiretroviral therapy (ART) standards. Methods: Medical visits and hospitalizations for any reason were from the HIV Research Network, a consortium of high-volume HIV primary care sites. HIV treatment drug regimen efficacies were from clinical guidelines and published sources; data on other drugs used were not available. In a computer simulation model, we projected HIV medical care costs in 2004 U.S. dollars. Results: From the time of entering HIV care, per person projected life expectancy is 24.2 years, discounted lifetime cost is $385,200, and undiscounted cost is $618,900 for adults who initiate ART with CD4 cell count < 350/mu L. Seventy-three percent of the cost is antiretroviral medications, 13% inpatient care, 9% outpatient care, and 5% other HIV-related medications and laboratory costs. For patients who initiate ART with CD4 cell count < 200/mu L, projected life expectancy is 22.5 years, discounted lifetime cost is $354,100 and undiscounted cost is $567,000. Results are sensitive to drug manufacturers' discounts, ART efficacy, and use of enfavirtide for salvage. If costs are discounted to the time of infection, the discounted lifetime cost is $303,100. Conclusions: Effective ART regimens have substantially improved survival and have increased the lifetime cost of HIV-related medical care in the U.S.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available