Economic impact of delaying or preventing AIDS in persons with HIV.
OBJECTIVE
To investigate how preventing or delaying the development of acquired immune deficiency syndrome (AIDS) [or other severe conditions related to the human immunodeficiency virus (HIV)] through antiretroviral therapy affects the lifetime cost of HIV/AIDS care, and to compare the cost of therapy with the potential savings in HIV/AIDS-related end-of-life care.


METHODS
The analysis utilized a previously developed economic model of HIV/AIDS-related medical care costs under various disease progression scenarios to compare the costs and benefits of antiretroviral therapy.


RESULTS
The analysis suggests that: (1) recent projections of long-term medical care cost savings due to highly effective protease inhibitor combination therapies are probably illusory; (2) it makes relatively little difference to the overall long-term cost of HIV/AIDS care whether combination antiretroviral therapy completely prevents or just substantially delays progression to AIDS; and (3) although combination therapy is not likely to save economic resources in the long run, it nevertheless can be highly cost effective.


CONCLUSIONS
The health-related benefits of antiretroviral therapy are not free, but appear to be worth the cost.
Pinkerton
S D
SD
Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee 53202, USA.
Holtgrave
D R
DR
D000163:Acquired Immunodeficiency Syndrome / Q000191:economics / Q000517:prevention & control*; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D017046:Cost Savings; D017281:Cost of Illness; D018450:Disease Progression; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics* / Q000503:physiopathology; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D019057:Quality-Adjusted Life Years; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D014481:United States
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors