Nonantiretroviral drug consumption by CD4 cell count in HIV-infected adults: a 5-year cohort study in Côte d'Ivoire.
We followed a cohort of 592 HIV-infected adults during 1292 person-years in Abidjan before the highly active antiretroviral therapy (HAART) era. On the basis of the exhaustive monitoring of nonantiretroviral drugs actually delivered to the patients and of the real cost of drugs at the cohort center's pharmacy during the study period, we estimated the mean cost of drugs per person per year (MCPPY) overall, by drug characteristics, and by patients' baseline CD4 cell count. The MCPPY was dollar 198 US overall and dolalr 83 US, dollar 101 US, dollar 186 US, dollar 233 US, and dollar 459 US in patients with a baseline CD4 count > or = 500 cells/mm, 350 to 499 cells/mm, 200 to 349 cells/mm, 100 to 199 cells/mm, and <100 cells/mm, respectively. The most costly classes of drugs were the antibacterial (MCPPY dollar 30 US), the antifungal (dollar 16 US), and the analgesic (dollar 6 US) classes in patients with a baseline CD4 count > or = 500 cells/mm versus the antifungal (dollar 208 US), the antibacterial (dollar 49 US), and the antiparasitic (dollar 31 US) classes in patients with a baseline CD4 count <100 cells/mm. These data could be used in further cost-effectiveness analyses that seek to prioritize health interventions. Meanwhile, they roughly suggest that successful antiretroviral treatment, which would stabilize the CD4 count above 500 cells/mm, could reduce by 5-fold the cost of nonantiretroviral drugs in HIV-infected adults in Abidjan.
Nombela
Nohelly
N
Unité INSERM U.593, Université Victor Segalen, Bordeaux, Cedex, France. mombe@yahoo.fr
Kouadio
Bertin
B
Toure
Siaka
S
Seyler
Catherine
C
Flori
Yves-Antoine
YA
Anglaret
Xavier
X
D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000191:economics*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D007560:Cote d'Ivoire; D003695:Delivery of Health Care / Q000191:economics*; D016527:Drug Costs; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics* / Q000276:immunology; D006801:Humans; D008297:Male; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000191:economics
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination