Krentz HB, Gill MJ; Conference on Retroviruses and Opportunistic Infections (11th : 2004 : San Francisco, Calif.).

Program Abstr Conf Retrovir Oppor Infect 11th 2004 San Franc Calif. 2004 Feb 8-11; 11: abstract no. 861.

Southern Alberta Clinic, Calgary, Canada and 2Univ. of Calgary, Alberta, Canada

BACKGROUND: The incidence of AIDS has decreased since the advent of highly active antiretroviral therapy (HAART), however, its prevalence has increased as patients are living longer after an AIDS diagnosis. We wished to measure and compare the direct costs of providing care to HIV-positive patients with and without an AIDS diagnostic illness.METHODS: The direct medical costs of all patients presenting for HIV care at the Southern Alberta Clinic (SAC), Calgary, Canada between April 1996 and April 2002 were included. SAC is the regional HIV care center for all HIV infected patients living in southern Alberta. Detailed sociodemographic, clinical, and direct costing data (i.e. all drug, outpatient, inpatient, and home care costs) were collected for each patient. A patient was considered to have AIDS if they were diagnosed with one of the 21 AIDS-defining illness. Mean costs are presented as cost per patient per month in 2002 Canadian dollars.RESULTS: Between 1996 and 2002 the incidence of AIDS in southern Alberta decreased from 119/1000 HIV patients per year to 40/1000 whereas the yearly prevalence remained stable at 22% of the HIV population. In 1994 prior to HAART 18% patients receiving care at SAC survived 36 months after an AIDS diagnosis; in 2000, 71% achieved 36 month survival. Within the region the cost of providing care to AIDS patients accounts for 32% of the annual total direct costs of all HIV care. The mean cost per patient per month for AIDS patients was 64% higher ($1528 vs $932) than for non-AIDS patients. Drug, outpatient, inpatient, and home care costs were 55%, 40%, 143%, 288% higher in AIDS patients respectively. These differences persist even when controlling for CD4 count. After the arrival of HAART mean costs per patient per month initially converged between AIDS and non-AIDS patients, however, costs have since diverged.CONCLUSIONS: The direct costs of AIDS care remains significantly higher than for non-AIDS patients and comprises a disproportional amount of the HIV care budget. Delaying or preventing AIDS remains economically as well as clinically important. Projected prevalence rates of AIDS need to be addressed when making any economic prediction on HIV care costs.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Alberta
• Antiretroviral Therapy, Highly Active
• CD4 Lymphocyte Count
• Canada
• Costs and Cost Analysis
• HIV Infections
• HIV Seropositivity
• Humans
• Incidence
• economics

Other ID:

• GWAIDS0031414

UI: 102271051

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