The lifetime cost of current human immunodeficiency virus care in the United States
The lifetime cost of current human immunodeficiency virus care in the United States
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DOI：
10.1097/01.mlr.0000228021.89490.2a
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发表时间：
2006-11-01
期刊：
影响因子：
3
通讯作者：
Freedberg, Kenneth A.
中科院分区：
文献类型：
--
作者：
Schackman, Bruce R.;Gebo, Kelly A.;Freedberg, Kenneth A.
Objective: We sought to project the lifetime cost of medical care for human immunodefiency virus (HIV)-infected adults using current antiretroviral therapy (ART) standards.Methods: Medical visits and hospitalizations for any reason were from the HIV Research Network, a consortium of high-volume HIV primary care sites. HIV treatment drug regimen efficacies were from clinical guidelines and published sources; data on other drugs used were not available. In a computer simulation model, we projected HIV medical care costs in 2004 U.S. dollars.Results: From the time of entering HIV care, per person projected life expectancy is 24.2 years, discounted lifetime cost is $385,200, and undiscounted cost is $618,900 for adults who initiate ART with CD4 cell count < 350/mu L. Seventy-three percent of the cost is antiretroviral medications, 13% inpatient care, 9% outpatient care, and 5% other HIV-related medications and laboratory costs. For patients who initiate ART with CD4 cell count < 200/mu L, projected life expectancy is 22.5 years, discounted lifetime cost is $354,100 and undiscounted cost is $567,000. Results are sensitive to drug manufacturers' discounts, ART efficacy, and use of enfavirtide for salvage. If costs are discounted to the time of infection, the discounted lifetime cost is $303,100.Conclusions: Effective ART regimens have substantially improved survival and have increased the lifetime cost of HIV-related medical care in the U.S.
