The oncology impact of highly active antiretroviral therapy.
OBJECTIVE
To examine the impact of using highly active antiretroviral therapy (HAART) in a human immunodeficiency virus (HIV) infected population on the chemotherapy related costs of treating acquired immunodeficiency (AIDS)-related cancers.


METHODS
We used the Southern Alberta Clinic (SAC) database to define the incidence and prevalence of AIDS-related cancers in a geographically defined HIV population in both the pre- HAART and HAART eras, and subsequently, the Alberta Cancer Board Pharmacy database to determine the chemotherapy associated costs of the cancer treatment.


RESULTS
During both eras, 60% of AIDS-related cancer patients received chemotherapy. The absolute number of patients treated in the pre-HAART era was 70, but during the HAART era, due to the decreased incidence of these cancers, only 13 patients received chemotherapy. The number of distinct regimens used for AIDS cancer treatment standardised, and decreased from 29 to six between eras. The average per patient cost of chemotherapy in the pre-HAART era was $6111, while in the HAART era it rose to $8817. However, the cost avoidance in chemotherapy costs, due to HAART use in the 'at risk' population, averaged $123 439/year or $471 per 'at risk' patient.


CONCLUSIONS
The introduction of HAART has dramatically reduced the amount spent on chemotherapy due to a decreased incidence of AIDSrelated cancers, even though the individual patient treatments have become more effective and expensive.
Schlichemeyer
Richard
R
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Chambers
Carole
C
Gill
M John
MJ
D000416:Alberta; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics; D016208:Databases, Factual; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000821:virology*; D015995:Prevalence
D000970:Antineoplastic Agents