HIV-related costs in public hospital settings: Impact of HAART

Antiretroviral (AR) therapy is associated with a lower incidence of opportunistic infections and hospitalization, but the cost of AR drugs is high. For publicly funded health care facilities, determining whether there is a total cost benefit in using AR therapy is important to ensure continued funding. In a study of AR therapy at the Veterans Affairs Medical Center in Dallas, we found a steep initial decline in total costs that coincided with the introduction of new regimens, including protease inhibitors and highly active antiretroviral therapy (HAART). As initial therapy on patients began to fail, however, costs increased with the use of more intensive regimens. A similar pattern of initial cost decrease followed by slight increase was found in another study of the publicly funded Parkland HIV/AIDS Clinic. Results still showed that it was more costly to treat patients who did not receive HAART than it was for those who did receive HAART regimens.