title: [Cost of Illness of HIV Patients under Anteretroviral Therapy in Germany - Results of the 48-Week Interim Analysis of the Prospective Multicentre Observational Study 'CORSAR'].
abstract: BACKGROUND
  With the introduction of highly active combined antiretroviral therapy (c-ART) mortality and morbidity of HIV patients declined substantially. Earlier studies reported that c-ART was able to save health-care costs due to a reduction of other direct medical costs, particularly for inpatient treatments and concomitant medication. To date, analyses of costs and health-related quality of life (HRQOL) of patients under c-ART are lacking in Germany. Hence, this study aims to estimate the current cost of illness and HRQOL of HIV-patients under c-ART in different treatment lines.
  
  
  METHODS
  A multicenter, prospective observational study was carried out in 12 specialised German centres for infectious diseases: 8 private practices/outpatient centres and 4 specialised hospitals offering both inpatient and outpatient services. Demographic, clinical and medication data were derived from patient records. Resource utilisation, information on productivity, out of pocket costs and HRQOL (EQ-5D) were collected every 12 weeks via a patient questionnaire. All costs were calculated based on price information from publicly accessible databases.
  
  
  RESULTS
  N=1,154 patients were included in the analysis. Mean direct disease-related costs of -patients under c-ART amounted to 22,563 Euro/year. Patients beyond the 3(rd) line of treatment -incurred considerably higher costs 24,654 Euro/year. In the 1(st) treatment line, c-ART accounted for 83.2% of the total direct costs, in the 2(nd)/3(rd) line for 80.8% and in >3(rd) line for 83.4%, respectively. Indirect costs due to impaired productivity were higher in the 2(nd)/3(rd) treatment line (2,843 Euro) compared to the 1(st) (1,604 Euro) and >3(rd) (1,752 Euro) treatment lines, respectively. The average HRQOL (EQ-5D) varied between 0.77 (self-assessment via visual analogue scale) and 0.91 (utility score based on the German time trade-off tariff).
  
  
  CONCLUSIONS
  Over the last decade, cost of illness of HIV patients under c-ART decreased slightly with average costs per year still being substantial. Main cost driver of overall costs is c-ART. There have been, however, noticeable shifts between different cost domains.
authors.affiliation: Center for Health Economics Research Hannover (CHERH), Leibniz -Universität Hannover, Hannover.
authors.forename: A
authors.initials: A
authors.lastname: Kuhlmann
authors.affiliation: Health Economic Research & Consulting, Herescon GmbH, Hannover.
authors.forename: T
authors.initials: T
authors.lastname: Mittendorf
authors.affiliation: ID-Ambulanz der Medizinischen Klinik Nord, Klinikum Dortmund, Dortmund.
authors.forename: M
authors.initials: M
authors.lastname: Hower
authors.affiliation: Innere Medizin, Praxis Georgstraße, Hannover.
authors.forename: H
authors.initials: H
authors.lastname: Heiken
authors.affiliation: Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover.
authors.forename: S
authors.initials: S
authors.lastname: Gerschmann
authors.affiliation: Infektiologie, Infektiologikum, Frankfurt.
authors.forename: S
authors.initials: S
authors.lastname: Klauke
authors.affiliation: Infektiologie, Infektiologikum, Frankfurt.
authors.forename: T
authors.initials: T
authors.lastname: Lutz
authors.affiliation: Infektionskrankheiten und klinische Immunologie, Ludwig-Maximilians-Universität München, München.
authors.forename: J
authors.initials: J
authors.lastname: Bogner
authors.affiliation: Infektiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
authors.forename: O
authors.initials: O
authors.lastname: Degen
authors.affiliation: Infektiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
authors.forename: J
authors.initials: J
authors.lastname: van Lunzen
authors.affiliation: ID-Ambulanz der Medizinischen Klinik Nord, Klinikum Dortmund, Dortmund.
authors.forename: C
authors.initials: C
authors.lastname: Bachmann
authors.affiliation: ICH Grindel, Infektionsmedizinisches Centrum Hamburg, Hamburg.
authors.forename: H J
authors.initials: HJ
authors.lastname: Stellbrink
authors.affiliation: Innere Medizin, Ärzteforum Seestraße, Berlin.
authors.forename: W
authors.initials: W
authors.lastname: Schmidt
authors.affiliation: Innere Medizin, Ärzteforum Seestraße, Berlin.
authors.forename: I
authors.initials: I
authors.lastname: Leistner
authors.affiliation: Health Economics & Pricing, Janssen-Cilag GmbH, Neuss.
authors.forename: J
authors.initials: J
authors.lastname: Mahlich
authors.affiliation: Health Economics & Pricing, Janssen-Cilag GmbH, Neuss.
authors.forename: B
authors.initials: B
authors.lastname: Ranneberg
authors.affiliation: Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover.
authors.forename: M
authors.initials: M
authors.lastname: Stoll
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D044966:Anti-Retroviral Agents / Q000191:economics* / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics; D017281:Cost of Illness; D005260:Female; D005858:Germany / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents