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The Body Covers: The 5th Conference on Retroviruses and Opportunistic Infections
Session 28: Epidemiology: Effects of HIV-1 Therapy on the Cost of Care and Hospitalization

February 2, 1998

‘The Cost of Having HAART’

Poster session abstracts 199-202, 204

Several groups examined the cost implications of Highly Active Antiretroviral Therapy (HAART). In each study , the expense of the drug regimen and of the necessary viral load tests (usually over $12,000 per year) was balanced against the savings realized through fewer hospitalizations and fewer clinic visits.

McCollum and colleagues (#200) approached the issue by defining a cost per successfully treated patient. For HAART, they defined this as $7,000 per year of life saved. The authors then compared this cost to that of other medical interventions for other diseases, such as:

  • the use of ACE-inhibitors for heart failure ($9,700 per year of life saved),
  • statin use for coronary artery disease ($21,000)
  • routine mammography screening ($30,000),
  • dialysis (> $50,000),
  • and various types of surgery (over $100,000 per year of life saved).

They concluded that the cost of HAART per life year saved compared very favorably to the costs of other commonly used medical interventions.

Anyone interested in these types of analysis should refer to the journal Pharmacoeconomics, 1996; 10:109-113, for an article written on this topic by investigators from The Johns Hopkins University.

A report from a Maryland HMO (#201) compared the increased cost of HAART and viral load testing to the fewer dollars spent on hospitalizations, and concluded that the additional expenditures were only partially offset by the savings. A group from Dallas (#204) found that the total cost per patient (in-patient and out-patient) strongly favored early and aggressive use of HAART. Indeed, they calculated that for every $1.00 spent on HAART, $8.60 was saved in other areas of care.

Taken together, these studies fail to demonstrate conclusively the cost implications of HAART. However, they do establish very successfully the framework for further debate and discussion.

See Also
More on the Economics of HIV Care

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