title: IANUA: a regional project for the determination of costs in HIV-infected patients.
abstract: HIV treatment is based on combined antiretroviral therapy (cART) which has substantially improved survival, thus resulting in an increase in patient life expectancy as well as in the cost of HIV-related medical care. Therefore, several cost effectiveness studies were implemented worldwide, with one specifically in the Liguria region (Italy), to compare the annual economic expense in this area for HIV services, and the related improvement in patients' health. The IANUA project is intended to implement both cost-effectiveness and cost-utility analysis, therefore data related to clinical indicators and perceived health status were collected, the latter using a questionnaire based on the EQ-5D-3L. Information about the antiretroviral drugs and the relative quantity that a patient withdraws from the hospital pharmacy every month were extracted from the regional "F-file". All data gathered were stored in the Ligurian HIV Network, a web platform developed by the DIBRIS - Medinfo laboratory. More than eight hundred questionnaires were collected, and data will be elaborated by economists and psychologists. The first statistical elaborations showed that, as expected, costs increased as the number of therapeutic lines increased. Moreover, the average annual costs for patients whose last CD4 values were below 200 cells/mmc corresponded to the maximum expense recorded, however, the cost for patients with final CD4 counts above 500 cells/mmc was not, as expected, the lowest found. This can be explained by the fact that stabilized patients, who had CD4 values below 500 cells/mmc, did not need very expensive care, while patients with CD4 counts above 500 cells/mmc improved their health status thanks to cART.
authors.affiliation: Dept. of Informatics, Bioengineering, Robotics & System Engineering (DIBRIS); Univ. of Genoa, I.
authors.forename: Barbara
authors.initials: B
authors.lastname: Giannini
authors.affiliation: Dept. of Informatics, Bioengineering, Robotics & System Engineering (DIBRIS); Univ. of Genoa, I.
authors.forename: Roberta
authors.initials: R
authors.lastname: Gazzarata
authors.affiliation: Department of Health and Social Services; Liguria Region, Genoa Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Orcamo
authors.affiliation: Department of Health and Social Services; Liguria Region, Genoa Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Merlano
authors.affiliation: Department of Infectious Diseases, Galliera Hospital, Genoa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cenderello
authors.affiliation: Department of Infectious Diseases, Galliera Hospital, Genoa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Venturini
authors.affiliation: Department of Infectious Diseases, IRCCS AOU San Martino - IST, Genoa, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Biagio
authors.affiliation: Department of Infectious Diseases, IRCCS AOU San Martino - IST, Genoa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mazzarello
authors.affiliation: Department of Economics; University of Genoa, Genoa, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Montefiori
authors.affiliation: Department of Economics; University of Genoa, Genoa, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Ameri
authors.affiliation: Department of Internal Medicine; University of Genoa, Genoa, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Setti
authors.affiliation: Department of Infectious Diseases, IRCCS AOU San Martino - IST, Genoa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Viscoli
authors.affiliation: Department of Infectious Diseases, Galliera Hospital, Genoa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cassola
authors.affiliation: Dept. of Informatics, Bioengineering, Robotics & System Engineering (DIBRIS); Univ. of Genoa, I.
authors.forename: Mauro
authors.initials: M
authors.lastname: Giacomini
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D015397:Program Evaluation; D012041:Regional Medical Programs / Q000191:economics* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires