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Study shows AIDS drugs cost-effective, care underfunded

New research shows that highly active antiretroviral therapy (HAART) is very cost-effective, despite the high price tag. However, the study also shows that reimbursement to physicians treating patients with HIV is critically low, threatening patients' access to care. The study findings are reported in the April 1 issue of Clinical Infectious Diseases, now available online.

While HAART has led to dramatic decreases in illness and death of patients with HIV, it does so at a price: the drug therapy averages $10,000-$15,000 a year for a single patient. To gauge whether HAART was cost-effective in treating HIV-infected patients, researchers previously relied on modeled estimates of health care expenditures. Now, using actual healthcare utilization data, researchers at the University of Alabama at Birmingham (UAB) have analyzed a year's worth of total health care expenditures for 635 HIV-infected patients, including HAART and non-HAART medications, hospitalization, outpatient clinic visits, and more.

According to the study, as long as a patient sticks to HAART treatment, "the happy paradox is that paying high costs for antiretrovirals decreases overall cost of care," said senior author Michael Saag, MD. The HAART costs were about the same for patients who were sicker ?that is, who had lower CD4 cell counts ?as for healthier patients with higher CD4 cell counts. But the sicker patients ran up much higher bills for other care: Expenditures were almost six times greater for hospitalizations, and almost eight times greater for non-HAART medications, for the sicker patients than for the healthier ones.

On average, the sicker HIV-infected patients have total annual health care expenditures 2.5 times higher than healthier ones -- about $36,500 a year compared with about $14,000 a year, the study found.

"This study confirms the remarkable cost effectiveness of HAART," said Dr. Saag. But it also underscores a grave threat to HIV treatment across
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Source:Infectious Diseases Society of America


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