Association of adherence to antiretroviral therapy with economic burden of cardiovascular disease in HIV-infected population

• Published in: European journal of preventive cardiology 2020-03, p.2047487320908085
• Main Authors: Liao, Chia-Te, Yang, Chun-Ting, Chen, Pin-Hao, Toh, Han Siong, Kuo, Shihchen, Chen, Zhih-Cherng, Ou, Huang-Tz, Ko, Nai-Ying, Wang, Jung-Der
• Format: Article
• Language: English
• ISSN: 2047-4881

There is a lack of studies that rigorously and systematically assess the economic burden of cardiovascular diseases (CVDs) related to the use of antiretroviral therapy (ART). We aimed to assess the association between adherence to ART and economic burden of CVDs in an HIV-infected population. Taiwan's National Health Insurance Research Database 2000-2011 was utilized for analyzing 18,071 HIV-infected patients free of CVDs before HIV diagnosis. The level of adherence to ART was measured by the medication possession ratio (MPR). Generalized estimating equations analysis was applied to estimate the cost impact of a variety of CVDs. All costs were presented in 2018 US dollars. The incidence of CVDs ranged from 0.17/1000 person-years (cardiogenic shock) to 2.60/1000 person-years (ischemic heart diseases (IHDs)). The mean annual medical cost for a base-case patient without CVDs was US$3000. Having cerebrovascular diseases, myocardial infarction, heart failure, arrhythmia, and IHDs increased annual costs by 41%, 33%, 30%, 16%, and 14%, respectively. The cost impact of incident CVDs in years with high adherence to ART (MPR ≥ 0.8) was significantly lower than that in years with low adherence (MPR