title: The cost of HIV disease in Northern Italy: the payer's perspective.
abstract: BACKGROUND
  Healthcare expenditures incurred by the Health Service for HIV-infected patients have not been reported in Italy.
  
  
  OBJECTIVE
  To present health care costs for HIV-infected patients in the Lombardy Region, in 2004-2007, to determine the clinical characteristics of HIV infection associated with costs.
  
  
  METHODS
  Retrospective, observational, budget impact study, based on information collected for the period 2004-2007, including hospitalizations, outpatient services, highly active antiretroviral therapy (HAART) and non-HAART drug utilization. Inclusion criteria includes: confirmed HIV infection, age ≥18 years, resident in Lombardy Region, and followed at the "L. Sacco" Hospital in Milan from 2004 to 2007.
  
  
  RESULTS
  The mean total cost per year to provide healthcare to HIV-positive patients was rather stable (€ 9658.36 in 2004 and € 9745.65 in 2007 (+0.90%)); HAART represented more than 60% of the total cost. We found that hepatitis C virus coinfection was related to higher costs (€ 11,003.45 vs. € 8896.06), as well as CD4 cell count <200 cells/mm (€ 12,681.36 vs. € 9594.11 and € 9450.36 in 200-499 and ≥500 cells/mm, respectively). The mean total cost of HIV health care was higher in patients who initiated antiretroviral treatment before 1997 than in those who started after 1996.
  
  
  CONCLUSIONS
  The mean total cost per year to provide health care to HIV-positive patients was stable during the period 2004-2007, with an increase of HAART percentage impact on the total cost. Several clinical characteristics of HIV-infected patients were significantly associated with cost variation.
authors.affiliation: First Infectious Diseases Department, Luigi Sacco Hospital, Milan, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Rizzardini
authors.forename: Umberto
authors.initials: U
authors.lastname: Restelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonfanti
authors.forename: Emanuele
authors.initials: E
authors.lastname: Porazzi
authors.forename: Elena
authors.initials: E
authors.lastname: Ricci
authors.forename: Luca
authors.initials: L
authors.lastname: Casartelli
authors.forename: Emanuela
authors.initials: E
authors.lastname: Foglia
authors.forename: Laura
authors.initials: L
authors.lastname: Carenzi
authors.forename: Paola
authors.initials: P
authors.lastname: Citterio
authors.forename: Giovanna
authors.initials: G
authors.lastname: Orlando
authors.forename: Carlo
authors.initials: C
authors.lastname: Maselli
authors.forename: Davide
authors.initials: D
authors.lastname: Croce
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics*; D005260:Female; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D019380:Anti-HIV Agents