Contemporary costs of HIV healthcare in the HAART era

Kelly A. Gebo, John A. Fleishman, Richard Conviser, James Hellinger, Fred J. Hellinger, Joshua S. Josephs, Philip Keiser, Paul Gaist, Richard D. Moore

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

Background: The delivery of HIV healthcare historically has been expensive. The most recent national data regarding HIV healthcare costs were from 1996-1998. We provide updated estimates of expenditures for HIV management. Methods: We performed a cross-sectional review of medical records at 10 sites in the HIV Research Network, a consortium of high-volume HIV care providers across the United States. We assessed inpatient days, outpatient visits, and prescribed antiretroviral and opportunistic illness prophylaxis medications for 14 691 adult HIV-infected patients in primary HIV care in 2006. We estimated total care expenditures, stratified by the median CD4 cell count obtained in 2006 (≤50, 51-200, 201-350, 351-500, >500 cells/μl). Per-unit costs of care were based on Healthcare Cost and Utilization Project (HCUP) data for inpatient care, discounted average wholesale prices for medications, and Medicare physician fees for outpatient care. Results: Averaging over all CD4 strata, the mean annual total expenditures per person for HIV care in 2006 in three sites was US $19 912, with an interquartile range from US $11 045 to 22 626. Average annual per-person expenditures for care were greatest for those with CD4 cell counts 50 cell/μl or less (US $40 678) and lowest for those with CD4 cell counts more than 500 cells/μl (US $16 614). The majority of costs were attributable to medications, except for those with CD4 cell counts 50 cells/μl or less, for whom inpatient costs were highest. Conclusion: HIV healthcare in the United States continues to be expensive, with the majority of expenditures attributable to medications. With improved HIV survival, costs may increase and should be monitored in the future.

Original languageEnglish (US)
Pages (from-to)2705-2715
Number of pages11
JournalAIDS
Volume24
Issue number17
DOIs
StatePublished - Nov 13 2010

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Highly Active Antiretroviral Therapy
Health Care Costs
HIV
Health Expenditures
CD4 Lymphocyte Count
Costs and Cost Analysis
Inpatients
Delivery of Health Care
Fees and Charges
Ambulatory Care
Medicare
Medical Records
Primary Health Care
Outpatients
Physicians
Survival

Keywords

  • CD4 cell count
  • cost
  • HAART
  • HIV
  • HIV Research Network
  • utilization

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Gebo, K. A., Fleishman, J. A., Conviser, R., Hellinger, J., Hellinger, F. J., Josephs, J. S., ... Moore, R. D. (2010). Contemporary costs of HIV healthcare in the HAART era. AIDS, 24(17), 2705-2715. https://doi.org/10.1097/QAD.0b013e32833f3c14

Contemporary costs of HIV healthcare in the HAART era. / Gebo, Kelly A.; Fleishman, John A.; Conviser, Richard; Hellinger, James; Hellinger, Fred J.; Josephs, Joshua S.; Keiser, Philip; Gaist, Paul; Moore, Richard D.

In: AIDS, Vol. 24, No. 17, 13.11.2010, p. 2705-2715.

Research output: Contribution to journalArticle

Gebo, KA, Fleishman, JA, Conviser, R, Hellinger, J, Hellinger, FJ, Josephs, JS, Keiser, P, Gaist, P & Moore, RD 2010, 'Contemporary costs of HIV healthcare in the HAART era', AIDS, vol. 24, no. 17, pp. 2705-2715. https://doi.org/10.1097/QAD.0b013e32833f3c14
Gebo KA, Fleishman JA, Conviser R, Hellinger J, Hellinger FJ, Josephs JS et al. Contemporary costs of HIV healthcare in the HAART era. AIDS. 2010 Nov 13;24(17):2705-2715. https://doi.org/10.1097/QAD.0b013e32833f3c14
Gebo, Kelly A. ; Fleishman, John A. ; Conviser, Richard ; Hellinger, James ; Hellinger, Fred J. ; Josephs, Joshua S. ; Keiser, Philip ; Gaist, Paul ; Moore, Richard D. / Contemporary costs of HIV healthcare in the HAART era. In: AIDS. 2010 ; Vol. 24, No. 17. pp. 2705-2715.
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