title: Medical resource utilization and cost of HIV-related care in the highly active antiretroviral therapy era at a University Clinic in Sweden.
abstract: BACKGROUND
  Little is known regarding healthcare costs for HIV/AIDS patients in the era of highly active antiretroviral therapy (HAART) and subgroups of patients according to the severity and progression of HIV infection in Sweden. The objective of this study is therefore to describe the direct medical resource use and cost of healthcare for HIV patients at a university clinic in Sweden.
  
  
  METHODS
  A patient registry database for HIV treatment at the Department of Infectious Diseases, Sahlgrenska University Hospital, between 2000 and 2005 provided information on patient characteristics, antiretroviral drugs and dosages, tests and diagnostic procedures, outpatient visits and inpatient stays. The review used publicly available unit costs with a county council perspective, expressed in 2006 Euros.
  
  
  RESULTS
  Two hundred and eighty-five patients with a mean age of 38 years in 2000 (64% men) were followed for 1368 patient-years. They had a mean (median) of 6.3 (0) inpatient days, 4.1 (3.7) physician visits, 4.2 (3.8) nurse visits, 2.6 (0.7) counsellor visits and 11.5 (7.7) tests and diagnostic procedures per patient-year. Only 12 deaths were recorded during the study period, and the proportion of treated patients with successful treatment (HIV-RNA < 50 copies/mL) increased from 74% to 92% during the period. The mean cost per patient-month amounted to €1069. The main cost driver was HIV drugs (51%), followed by inpatient stays (including hospitalizations for opportunistic infections; 22%), outpatient physician, nurse or therapist visits (19%) and diagnostics and tests (7%). All non-drug costs increased with a decreasing CD4 cell count.
  
  
  CONCLUSIONS
  Overall, approximately half of the direct costs of HIV treatment were not related to antiretroviral treatment. The non-antiretroviral costs were inversely correlated with HIV-induced immune deficiency.
authors.affiliation: The Swedish Institute for Health Economics (IHE), Lund, Sweden. og@ihe.se
authors.forename: Ola
authors.initials: O
authors.lastname: Ghatnekar
authors.forename: Catharina
authors.initials: C
authors.lastname: Hjortsberg
authors.forename: Magnus
authors.initials: M
authors.lastname: Gisslén
authors.forename: Stefan
authors.initials: S
authors.lastname: Lindbäck
authors.forename: Mickael
authors.initials: M
authors.lastname: Löthgren
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000191:economics*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics*; D018450:Disease Progression; D016527:Drug Costs; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D013548:Sweden; D014495:Universities / Q000191:economics; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents