Cost-effectiveness of highly active antiretroviral therapy for HIV infection in Taiwan.
Cost-effectiveness of highly active antiretroviral therapy for HIV infection in Taiwan.
复制标题
台湾针对艾滋病毒感染的高效抗逆转录病毒疗法的成本效益。
DOI：
10.1016/s0929-6646(08)60020-0
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Wang,Jung-Der
中科院分区：
文献类型：
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作者：
Fang,Chi-Tai;Chang,Yu-Yin;Hsu,Hsu-Mei;Twu,Shiing-Jer;Chen,Kow-Tong;Chen,Mao-Yuan;Huang,LoreenYL;Hwang,Jing-Shiang;Wang,Jung-Der
自20世纪80年代末以来，台湾政府向所有感染艾滋病毒的公民提供免费的抗逆转录病毒治疗。最近，关于是否应该继续为艾滋病毒感染患者免费提供昂贵的高效抗逆转录病毒治疗(HAART)存在争议。本研究旨在评价HAART治疗的成本-效果。方法：通过分析1984年4月至1997年3月(HAART前)和1997年5月至2003年4月(HAART前)台湾地区所有HIV阳性患者的随访数据，得出与HAART相关的生存改善。HIV阳性患者的生活质量数据来自对224名患者的横断面调查，使用标准GAMBLE方法和世界卫生组织生活质量-BREF量表。关于HAART费用的信息从国家健康保险(NHI)获得。结果：2000年，每名接受HAART的HIV阳性患者平均每年用于HAART的NHI费用为新台币210,018元(6177美元，按新台币/美元的汇率计算)。在艾滋病组，每增加一个生命年的成本为176,441元新台币(5,189美元)，每增加一个质量调整的生命年成本为241,700元新台币(7,109美元)。非爱滋病患者的相应费用分别为226,156新台币(6,652美元)和332,582新台币(9,782美元)。这些估计还没有包括与HAART相关的住院和机会性感染抗菌剂使用的减少所节省的额外成本，以及在HAART普及的情况下减少艾滋病毒传播所获得的额外寿命。结论：HAART治疗HIV感染是具有成本效益的，特别是在考虑到社会和流行病学因素的情况下。我们建议继续向所有感染艾滋病毒的公民提供免费抗逆转录病毒疗法的政策。
Since the late 1980s, the Taiwanese government has provided all HIV-infected citizens with free access to antiretroviral therapy. Recently, there is controversy as to whether or not free access to expensive highly active antiretroviral therapy (HAART) should be continued for HIV-infected patients. This study aimed to evaluate the cost-effectiveness of HAART therapy. METHODS: HAART-associated improvement in survival was obtained by analyzing the follow-up data of all HIV-positive patients identified during April 1984 to March 1997 (pre-HAART era) and May 1997 to April 2003 (HAART era) in Taiwan. Data on quality of life in HIV-positive patients was obtained from a cross-sectional survey of 224 patients using standard gamble method and World Health Organization Quality of Life-BREF instrument. Information regarding the cost of HAART was obtained from the National Health Insurance (NHI). RESULTS: In 2000, the average annual NHI expenditure on HAART per HIV-positive patient receiving HAART was NT$210,018 (US$6177, at an exchange rate of 34.0 NT$/US$). In the AIDS group, the cost was NT$176,441 (US$5189) per life year gained and NT$241,700 (US$7109) per quality-adjusted life year gained. For non-AIDS patients, the corresponding costs were NT$226,156 (US$6652) and NT$332,582 (US$9782), respectively. These estimates have not yet included the additional cost savings from HAART-associated reduction in hospitalization and use of antimicrobial agents for opportunistic infections, and the additional life years gained from the reduction in HIV transmission under the universal availability of HAART CONCLUSION: HAART for HIV infection is cost-effective, especially when the societal and epidemiologic factors are considered. We recommend that the policy of providing free HAART to all HIV-infected citizens be continued.