Details
| Original language | English |
|---|---|
| Article number | e3961 |
| Journal | Medicine (United States) |
| Volume | 95 |
| Issue number | 26 |
| Publication status | Published - Jun 2016 |
Abstract
To analyze contemporary costs of HIV health care and the cost distribution across lines of combination antiretroviral therapy (cART). To identify variations in expenditures with patient characteristics and to identify main cost determinants. To compute cost ratios between patients with varying characteristics. Empirical data on costs are collected in Germany within a 2-year prospective observational noninterventional multicenter study. The database contains information for 1154 HIV-infected patients from 8 medical centers. Means and standard deviations of the total costs are estimated for each cost fraction and across cART lines and regimens. The costs are regressed against various patient characteristics using a generalized linear model. Relative costs are calculated using the resultant coefficients. The average annual total costs (SD) per patient are €22,231.03 (8786.13) with a maximum of €83,970. cART medication is the major cost fraction (83.8%) with a mean of €18,688.62 (5289.48). The major cost-driving factors are cART regimen, CD4-T cell count, cART drug resistance, and concomitant diseases. Viral load, pathology tests, and demographics have no significant impact. Standard non-nucleoside reverse transcriptase inhibitor-based regimens induce 28% lower total costs compared with standard PI/r regimens. Resistance to 3 or more antiretroviral classes induces a significant increase in costs. HIV treatment in Germany continues to be expensive. Majority of costs are attributable to cART. Main cost determinants are CD4-T cells count, comorbidity, genotypic antiviral resistance, and therapy regimen. Combinations of characteristics associated with higher expenditures enhance the increasing effect on the costs and induce high cost cases.
Keywords
- combination antiretroviral therapy, cost determinants, cost ratios, costs, HIV, prospective cohort survey, utilization
ASJC Scopus subject areas
- Medicine(all)
- General Medicine
Sustainable Development Goals
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In: Medicine (United States), Vol. 95, No. 26, e3961, 06.2016.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Analysis of contemporary HIV/AIDS health care costs in Germany
T2 - Driving factors and distribution across antiretroviral therapy lines
AU - Treskova, Marina
AU - Kuhlmann, Alexander
AU - Bogner, Johannes
AU - Hower, Martin
AU - Heiken, Hans
AU - Stellbrink, Hans Jürgen
AU - Mahlich, Jörg
AU - Von Der Schulenburg, Johann Matthias Graf
AU - Stoll, Matthias
PY - 2016/6
Y1 - 2016/6
N2 - To analyze contemporary costs of HIV health care and the cost distribution across lines of combination antiretroviral therapy (cART). To identify variations in expenditures with patient characteristics and to identify main cost determinants. To compute cost ratios between patients with varying characteristics. Empirical data on costs are collected in Germany within a 2-year prospective observational noninterventional multicenter study. The database contains information for 1154 HIV-infected patients from 8 medical centers. Means and standard deviations of the total costs are estimated for each cost fraction and across cART lines and regimens. The costs are regressed against various patient characteristics using a generalized linear model. Relative costs are calculated using the resultant coefficients. The average annual total costs (SD) per patient are €22,231.03 (8786.13) with a maximum of €83,970. cART medication is the major cost fraction (83.8%) with a mean of €18,688.62 (5289.48). The major cost-driving factors are cART regimen, CD4-T cell count, cART drug resistance, and concomitant diseases. Viral load, pathology tests, and demographics have no significant impact. Standard non-nucleoside reverse transcriptase inhibitor-based regimens induce 28% lower total costs compared with standard PI/r regimens. Resistance to 3 or more antiretroviral classes induces a significant increase in costs. HIV treatment in Germany continues to be expensive. Majority of costs are attributable to cART. Main cost determinants are CD4-T cells count, comorbidity, genotypic antiviral resistance, and therapy regimen. Combinations of characteristics associated with higher expenditures enhance the increasing effect on the costs and induce high cost cases.
AB - To analyze contemporary costs of HIV health care and the cost distribution across lines of combination antiretroviral therapy (cART). To identify variations in expenditures with patient characteristics and to identify main cost determinants. To compute cost ratios between patients with varying characteristics. Empirical data on costs are collected in Germany within a 2-year prospective observational noninterventional multicenter study. The database contains information for 1154 HIV-infected patients from 8 medical centers. Means and standard deviations of the total costs are estimated for each cost fraction and across cART lines and regimens. The costs are regressed against various patient characteristics using a generalized linear model. Relative costs are calculated using the resultant coefficients. The average annual total costs (SD) per patient are €22,231.03 (8786.13) with a maximum of €83,970. cART medication is the major cost fraction (83.8%) with a mean of €18,688.62 (5289.48). The major cost-driving factors are cART regimen, CD4-T cell count, cART drug resistance, and concomitant diseases. Viral load, pathology tests, and demographics have no significant impact. Standard non-nucleoside reverse transcriptase inhibitor-based regimens induce 28% lower total costs compared with standard PI/r regimens. Resistance to 3 or more antiretroviral classes induces a significant increase in costs. HIV treatment in Germany continues to be expensive. Majority of costs are attributable to cART. Main cost determinants are CD4-T cells count, comorbidity, genotypic antiviral resistance, and therapy regimen. Combinations of characteristics associated with higher expenditures enhance the increasing effect on the costs and induce high cost cases.
KW - combination antiretroviral therapy
KW - cost determinants
KW - cost ratios
KW - costs
KW - HIV
KW - prospective cohort survey
KW - utilization
UR - http://www.scopus.com/inward/record.url?scp=84978661379&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000003961
DO - 10.1097/MD.0000000000003961
M3 - Article
C2 - 27367993
AN - SCOPUS:84978661379
VL - 95
JO - Medicine (United States)
JF - Medicine (United States)
SN - 0025-7974
IS - 26
M1 - e3961
ER -