Costing of scaling up HIV/AIDS treatment in Mexico.
OBJECTIVE
To determine the net effect of introducing highly active antiretroviral treatment (HAART) in Mexico on total annual per-patient costs for HIV/AIDS care, taking into account potential savings from treatment of opportunistic infections and hospitalizations.


METHODS
A multi-center, retrospective patient chart review and collection of unit cost data were performed to describe the utilization of services and estimate costs of care for 1003 adult HIV+ patients in the public sector.


RESULTS
HAART is not cost-saving and the average annual cost per patient increases after initiation of HAART due to antiretrovirals, accounting for 90% of total costs. Hospitalizations do decrease post-HAART, but not enough to offset the increased cost.


CONCLUSIONS
Scaling up access to HAART is feasible in middle income settings. Since antiretrovirals are so costly, optimizing efficiency in procurement and prescribing is paramount. The observed adherence was low, suggesting that a proportion of these high drug costs translated into limited health benefits.
Bautista-Arredondo
Sergio
S
Health Economics Division, National Institute of Public Health, Cuernavaca, Mexico.
Dmytraczenko
Tania
T
Kombe
Gilbert
G
Bertozzi
Stefano M
SM
D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics* / Q000706:statistics & numerical data; D018791:CD4 Lymphocyte Count; D003365:Costs and Cost Analysis; D004363:Drug Utilization / Q000191:economics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006268:Health Facilities / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008483:Medical Assistance / Q000191:economics; D008800:Mexico; D008875:Middle Aged; D011306:Prescription Fees / Q000706:statistics & numerical data; D017150:Public Sector / Q000191:economics; D012189:Retrospective Studies; D012494:Sampling Studies; D012943:Social Security / Q000191:economics; D013727:Terminal Care / Q000191:economics
D019380:Anti-HIV Agents