The Cost of HIV Treatment and Care

Abstract

This review of published studies on the costs of HIV treatment and care describes some of the recent developments that have influenced these costs in industrialised and industrialising countries, especially within the context of changing drug treatments. Some of the different approaches to estimating the economic impact of HIV infection are briefly presented. The methods used to review the literature are described, particularly the criteria of a scoring system that was specifically developed to systematically screen some of the studies identified. The mean review score for studies dealing with direct hospital costs increased significantly (p = 0.003) over the 3 periods analysed (before 1987, 1987 to 1995, and 1996 and beyond), indicating that the overall 'quality' of studies increased over time. All cost estimates, other than those from non-industrialised regions, were converted to 1996 US dollars using country-specific total health expenditure inflaters and country-specific Gross Domestic Product Purchasing Power Parity converters. A summary of hospital cost estimates over time and by region demonstrated that the costs of treating asymptomatic individuals and people with symptomatic non-AIDS increased over the period, but that the costs of treating individuals with AIDS appears to have stabilised since the late 1980s. As fewer studies could be identified on the costs of community and informal care, indirect productivity costs and population cost estimates, and costs of care for children with HIV infection, all of these studies were reviewed without the use of the scoring system. Finally, the discussion explores the evidence on the global costs of HIV in non-industrialised economies and the affordability of HIV treatment and care. Some suggestions for the direction of future HIV costing studies are also presented. A need remains for good quality cost data. Adequate research effort should be directed to improving the scope and quality of information on costs of HIV service provision around the world.

Costs and cost–effectiveness of HIV community services: quantity and quality of studies published 1986–2011

“…Information on the cost of programs or services and their effi ciency constitute important aspects of such strategic information [12,13] . Reviews of facility-based costs studies and cost-effectiveness studies, however, indicated profound limitations of published cost information [3,14,15] . Problems identifi ed included lack of standardized methods used for costing services, affecting the robustness of the analyses and the results obtained, raising serious questions on the quality of many of the reported fi ndings.…”

Cost of medical care for HIV‐infected patients within a regional population from 1997 to 2006

“…ART has been shown to be cost-effective [9,[12][13][14], but frequent changes and improvements in HIV care necessitate close monitoring of the direct cost landscape [15,16]. Changes in guidelines for wider HIV testing and for starting HIV therapy at higher CD4 thresholds [17] will not only lead to more patients requiring therapy but will also increase the per-patient costs [18].…”

“…We attributed the stability to the counterbalancing effects of decreased costs because of delaying or interrupting therapy with the increased costs of more widespread use of potent ART regimens of more than three drugs [3]. Other studies have shown similar effects in a broad variety of studies conducted in the same era in several different countries [4][5][6][7][8][9][10][11].ART has been shown to be cost-effective [9,[12][13][14], but frequent changes and improvements in HIV care necessitate close monitoring of the direct cost landscape [15,16]. Changes in guidelines for wider HIV testing and for starting HIV therapy at higher CD4 thresholds [17] will not only lead to more patients requiring therapy but will also increase the per-patient costs [18].…”

A Live Experiences on Quality of Life Among HIV Positive Patients

“…With the recent advances in clinical tests and treatments for those suffering from human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), the survival of these patients has been increased and their QOL has become an important focus for researchers and healthcare providers [2]. Since the discovery, HIV/AIDS has been one of the greatest health problems in the world [3] and it places an increasing burden on the health of the population, and causes further socioeconomic problems for individuals, families, communities, and governments in many countries [4,5].…”