[Antiretroviral therapy in HIV infection. Effects of the introduction of new drugs on health care expenditures, 1994-1999].
The administration of antiretroviral compounds to our cohort of HIV-infected patients was assessed since 1994, on the ground of some epidemiological, clinical, and therapeutic variables. During the six-year study period, a significant increase of mean prescription rate of overall anti-HIV agents was observed, with a nearly 10-fold rise of mean prescribed daily doses per 1,000 patients-year. In particular, lamivudine and indinavir represented the most frequently administered drugs, among nucleoside analogues and protease inhibitors, respectively. A significant increase of the percentage of HIV-infected patients undergoing combined antiretroviral therapy (79.3% in 1999), and the mean number of drugs prescribed per patient (3.02 in 1999), was concurrently detected. The progressive changes of antiretroviral therapy guidelines were responsible for a nearly 16-fold increase of expenditures directly related to antiretroviral drug administration in 1999 compared with 1994 (with over 41% of costs related to protease inhibitors). On the other hand, a substantial modification of HIV disease evolution occurred in our patient cohort in terms of absolute morbidity and mortality figures, as expressed by a drop of notified AIDS cases and AIDS-related deaths ranging from 2.5 to 5 times, during the considered period.
Manfredi
R
R
Dipartimento di Medicina Clinica Specialistica e Sperimentale, Università, Bologna.
Fiacchi
P
P
Riolo
U
U
Chiodo
F
F
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use*; D015331:Cohort Studies; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D005102:Health Expenditures; D006801:Humans; D019469:Indinavir / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D019259:Lamivudine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D019469:Indinavir