Estimated Lifetime HIV-related Medical Costs in the United States.

Abstract:

BACKGROUND:Lifetime cost estimates are a useful tool in measuring the economic burden of HIV in the United States. Previous estimation methods need to be updated, given improving antiretroviral therapy regimens and updated costs. METHODS:We used an updated version of the agent-based model Progression and Transmission of HIV (PATH) 3.0 to reflect current regimens and costs. We simulated a cohort of those infected in 2015 until the last person had died to track the lifetime costs for treatment of HIV, including HIV health care utilization costs (inpatient, outpatient, opportunistic infection (OI) prophylaxis, non-HIV medication, and emergency department), OI treatment costs, and testing costs. We assumed a median per-person diagnosis delay of 3 years and a 3% base monthly probability of dropout from care for a base-case scenario. Additionally, we modeled a most-favorable scenario (median diagnosis delay of 1 year and 1% base dropout rate) and a least-favorable scenario (median diagnosis delay of 5 years and 5% base dropout rate). RESULTS:We estimated an average lifetime HIV-related medical cost for a person with HIV of $420,285 (2019 US$) discounted (3%) and $1,079,999 undiscounted for a median 3-year diagnosis delay and 3% base dropout rate. Our discounted cost estimate was $490,045 in our most-favorable scenario and $326,411 in our least-favorable scenario. CONCLUSIONS:Lifetime per-person HIV-related medical costs depend on the time from infection to diagnosis and the likelihood of dropping out of care. Our results, which are similar to previous studies, reflect updated ART regimens and costs for HIV treatment.

journal_name

Sex Transm Dis

authors

Bingham A,Shrestha RK,Khurana N,Jacobson E,Farnham PG

doi

10.1097/OLQ.0000000000001366

subject

Has Abstract

pub_date

2021-01-23 00:00:00

eissn

0148-5717

issn

1537-4521

pii

00007435-900000000-97769

pub_type

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