Updated direct costs of medical care for HIV‐infected patients within a regional population from 2006 to 2017

• Published in: HIV medicine 2020-05, Vol.21 (5), p.289-298
• Main Authors: Krentz, HB, Vu, Q, Gill, MJ
• Format: Article
• Language: English
• Subjects: Accounting; Annual variations; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Canada; CD4 antigen; cost of care; Costs; Drugs; Health services; HIV; HIV/AIDS; Hospital costs; hospitalizations; Human immunodeficiency virus; Laboratories; Patients
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/hiv.12824

Objectives The aim of the study was to reappraise the precise costs of HIV care and cost drivers, to determine the optimal tools for modelling costs for HIV care, and to understand the implications of changing medical management of HIV‐infected patients for both subsequent outcomes and health care budgets. Methods We obtained all drug, laboratory, out‐patient and in‐patient care costs for all HIV‐infected patients followed between 1 January 2006 and 31 December 2017 (2017 Cdn$). Mean cost per patient per month (PPPM) was used as the standard comparator value. Patients were stratified based on CD4 count: (1) ≤ 75, (2) 76–200, (3) 201–500 and (4) > 500 cells/μL. We determined the cost for only HIV‐related expenses. We compared current costs with costs previously reported for the same population. Results The number of HIV‐infected patients in care doubled from 2006 to 2017; total costs increased from $12.4 to $30.1 million, with antiretroviral (ARV) drugs accounting for 78.8% of costs by 2017. Out‐patient/laboratory costs declined from 12% to 8.5%, while in‐patient costs exhibited more annual variation. Mean PPPM costs increased from $1316 in 2006 to $1712 in 2014, declining to $1446 in 2017. Higher PPPM costs were associated with CD4 counts