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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Health Services Research 1/2018

How has the cost of antiretroviral therapy changed over the years? A database analysis in Italy

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2018
Autoren:
Lucia Taramasso, Federica Demma, Rossella Bitonti, Antonio Ferrazin, Barbara Giannini, Mauro Giacomini, Sabrina Beltramini, Elisabetta Sasso, Claudio Viscoli, Antonio Di Biagio
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12913-018-3507-x) contains supplementary material, which is available to authorized users.

Abstract

Background

The number of human immunodeficiency virus (HIV)-related hospitalizations has decreased worldwide in recent years, due to the availability of combined antiretroviral therapies (cART). The present analysis aimed to analyse the economic, and clinical burden of HIV management, after the introduction of systematic use of cART.

Methods

Data from HIV-infected patients, treated at Policlinico San Martino Hospital in Genova (Italy) were retrospectively collected. A comparison between years 2009 and 2015 was performed. HIV-related admissions were identified by using the Diagnosis-Related Group (DRG) codes. The resource consumption of outpatient services was derived by using a modelling approach. Expenditure for drugs was also analysed, as aggregate data.

Results

The number of HIV-infected patients was 898 in 2009 and 1006 in 2015. Overall, the virological success rate improved from 2009 to 2015, as the percentage of patients with HIV-RNA < 50 copies/mL increased from 79 to 89% (P < 0.05). The average incidence of hospitalizations per-patient decreased from 0.30 in 2009, to 0.13 in 2015. Average expenditure per-patient decreased from €10,107 in 2009 to €9063 in 2015.

Conclusions

The present analysis confirmed the role of cART in controlling HIV viral load and, consequently, in reducing hospitalizations, admissions to day-hospital and the use of outpatient services.
Clinical improvements and economic savings more than compensated the investments required to treat HIV-infected patients with cART. Health Authorities should invest in modern cART supply and universal treatment, to use at best the available resources and obtain a cost-effective improvement of health in people living with HIV. Additional research, with the involvement of different centers and the use of patient-specific data, are recommended to consolidate the findings of this analysis.
Zusatzmaterial
Additional file 1: Table S1. Results of the hospital care expenditure analysis. Table S2. Unit costs considered to evaluate ambulatory care expenditure. (DOCX 18 kb)
12913_2018_3507_MOESM1_ESM.docx
Literatur
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