Hospital costs of treating haemophilic patients infected with HIV

Abstract

Objective: To calculate the costs of treating HIV-infected haemophilic patients.

Design: Two-year retrospective study of hospital-based resource use and costs, from April 1991 to March 1993.

Setting: Haemophilia Centre and Haemostasis Unit, Royal Free Hospital and School of Medicine, London, UK.

Patients: Sixty patients infected with HIV between October 1979 and July 1985.

Results: During the 2-year period a total of 1668 hospital visits were made by patients. The mean number of episodes per patient-year (PY) was 0.6 inpatient admissions, 11.5 outpatient visits and 1.8 day cases. The mean cost per PY was 32,528 pounds, with the majority of this spent on clotting factor concentrate products and haemophilia inpatient admissions (81%). A mean cost for HIV-related treatment of 6050 pounds was estimated. The additional cost incurred in switching this group of haemophilic patients from intermediate-purity factor concentrate to high-purity products was 8614 pounds per PY. When clotting factor concentrate and expenditure on haemophilia-related inpatient admissions were excluded, the mean cost of treating HIV infection per PY was 6065 pounds, varying with CD4+ count (< or = 50 x 10(6)/l, 13,093 pounds; 51-200 x 10(6)/l, 6521 pounds; 201-500 x 10(6)/l, 2848 pounds; > 501 x 10(6)/l, 1497 pounds).

Conclusions: CD4+ count may be used as a marker of costs of HIV infection. The HIV-related cost estimates can be used for the planning of current and future hospital-based care in the National Health Service in the United Kingdom. The switch from intermediate-purity factor concentrate to high-purity products has increased the mean HIV-related cost per PY of treating haemophilic patients infected with HIV.