title: Projected Lifetime Healthcare Costs Associated with HIV Infection.
abstract: OBJECTIVE
  Estimates of healthcare costs associated with HIV infection would provide valuable insight for evaluating the cost-effectiveness of possible prevention interventions. We evaluate the additional lifetime healthcare cost incurred due to living with HIV.
  
  
  METHODS
  We used a stochastic computer simulation model to project the distribution of lifetime outcomes and costs of men-who-have-sex-with-men (MSM) infected with HIV in 2013 aged 30, over 10,000 simulations. We assumed a resource-rich setting with no loss to follow-up, and that standards and costs of healthcare management remain as now.
  
  
  RESULTS
  Based on a median (interquartile range) life expectancy of 71.5 (45.0-81.5) years for MSM in such a setting, the estimated mean lifetime cost of treating one person was £ 360,800 ($567,000 or € 480,000). With 3.5% discounting, it was £ 185,200 ($291,000 or € 246,000). The largest proportion (68%) of these costs was attributed to antiretroviral drugs. If patented drugs are replaced by generic versions (at 20% cost of patented prices), estimated mean lifetime costs reduced to £ 179,000 ($ 281,000 or € 238,000) and £ 101,200 ($ 158,900 or € 134,600) discounted.
  
  
  CONCLUSIONS
  If 3,000 MSM had been infected in 2013, then future lifetime costs relating to HIV care is likely to be in excess of £ 1 billion. It is imperative for investment into prevention programmes to be continued or scaled-up in settings with good access to HIV care services. Costs would be reduced considerably with use of generic antiretroviral drugs.
authors.affiliation: Research Department of Infection and Population Health, UCL, London, United Kingdom.
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Nakagawa
authors.affiliation: Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Alec
authors.initials: A
authors.lastname: Miners
authors.affiliation: Research Department of Infection and Population Health, UCL, London, United Kingdom.
authors.forename: Colette J
authors.initials: CJ
authors.lastname: Smith
authors.affiliation: HIV and STI Department, Public Health England, London, United Kingdom.
authors.forename: Ruth
authors.initials: R
authors.lastname: Simmons
authors.affiliation: Research Department of Primary Care and Population Health, UCL, London, United Kingdom.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Lodwick
authors.affiliation: Research Department of Infection and Population Health, UCL, London, United Kingdom.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cambiano
authors.affiliation: Copenhagen HIV Programme (CHIP), Department of Infectious Diseases (8632), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jens D
authors.initials: JD
authors.lastname: Lundgren
authors.affiliation: HIV and STI Department, Public Health England, London, United Kingdom.
authors.forename: Valerie
authors.initials: V
authors.lastname: Delpech
authors.affiliation: Research Department of Infection and Population Health, UCL, London, United Kingdom.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Phillips
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000191:economics; D016568:Drugs, Generic / Q000191:economics; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D018803:Models, Economic; D010330:Patents as Topic
chemical_list: D016568:Drugs, Generic