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. 2015 Apr 22;10(4):e0125018.
doi: 10.1371/journal.pone.0125018. eCollection 2015.

Projected Lifetime Healthcare Costs Associated with HIV Infection

Fumiyo Nakagawa  1 , Alec Miners  2 , Colette J Smith  1 , Ruth Simmons  3 , Rebecca K Lodwick  4 , Valentina Cambiano  1 , Jens D Lundgren  5 , Valerie Delpech  3 , Andrew N Phillips  1
Affiliations

Projected Lifetime Healthcare Costs Associated with HIV Infection

Fumiyo Nakagawa et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Distribution of costs spent in an average lifetime in base case analysis.
Fig 2
Fig 2. Distribution of costs spent in an average lifetime in analysis if patented drugs are replaced by generic versions.
See this image and copyright information in PMC

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