title: Direct treatment costs of HIV/AIDS in Portugal.
abstract: OBJECTIVE
  To analyze the direct medical costs of HIV/AIDS in Portugal from the perspective of the National Health Service.
  
  
  METHODS
  A retrospective analysis of medical records was conducted for 150 patients from five specialized centers in Portugal in 2008. Data on utilization of medical resources during 12 months and patients' characteristics were collected. A unit cost was applied to each care component using official sources and accounting data from National Health Service hospitals.
  
  
  RESULTS
  The average cost of treatment was 14,277 €/patient/year. The main cost-driver was antiretroviral treatment (€ 9,598), followed by hospitalization costs (€ 1,323). Treatment costs increased with the severity of disease from € 11,901 (> 500 CD4 cells/µl) to € 23,351 (CD4 count ≤ 50 cells/ µl). Cost progression was mainly due to the increase in hospitalization costs, while antiretroviral treatment costs remained stable over disease stages.
  
  
  CONCLUSIONS
  The high burden related to antiretroviral treatment is counterbalanced by relatively low hospitalization costs, which, however, increase with severity of disease. The relatively modest progression of total costs highlights that alternative public health strategies that do not affect transmission of disease may only have a limited impact on expenditure, since treatment costs are largely dominated by constant antiretroviral treatment costs.
authors.forename: Julian
authors.initials: J
authors.lastname: Perelman
authors.forename: Joana
authors.initials: J
authors.lastname: Alves
authors.forename: Ana Cláudia
authors.initials: AC
authors.lastname: Miranda
authors.forename: Céu
authors.initials: C
authors.lastname: Mateus
authors.forename: Kamal
authors.initials: K
authors.lastname: Mansinho
authors.forename: Francisco
authors.initials: F
authors.lastname: Antunes
authors.forename: Joaquim
authors.initials: J
authors.lastname: Oliveira
authors.forename: José
authors.initials: J
authors.lastname: Poças
authors.forename: Manuela
authors.initials: M
authors.lastname: Doroana
authors.forename: Rui
authors.initials: R
authors.lastname: Marques
authors.forename: Eugénio
authors.initials: E
authors.lastname: Teófilo
authors.forename: João
authors.initials: J
authors.lastname: Pereira
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal; D012189:Retrospective Studies