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HIV prevention yields significant lifetime medical cost savings

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SEATTLE — Considering the high lifetime medical costs of HIV treatment in the United States, the possible cost savings of HIV prevention is significant, according to recent findings.

“Enhanced HIV prevention interventions, such as pre-exposure prophylaxis for high-risk individuals, require substantial investments,” the researchers wrote in an abstract presented at CROI 2015. “We sought to estimate the medical costs saved by averting one HIV infection in the United States.”

To estimate the lifetime medical costs of individuals with and without HIV, the researchers used a computer simulation model of HIV disease and treatment to project CD4 cell count, ART status and mortality after HIV infection. Yearly medical cost estimates for HIV patients, which were taken from the HIV Research Network, ranged from $1,854 to $4,545 per month, adjusted for age, gender, race/ethnicity and transmission risk status. Costs for individuals without HIV, drawn from the Medical Expenditure Panel Survey, ranged from $73 to $628 monthly. The researchers reported the results as lifetime medical costs from the perspective of a U.S. health system, discounted at 3% (2012 dollars).

For an individual infected with HIV at age 35 years, the estimated reduced lifetime cost was $326,500 (60% for ART, 15% for other medications and 25% for costs not associated with drugs). For high-risk individuals who did not become infected with HIV, the discounted lifetime cost was estimated at $96,700. The researchers projected the medical cost savings of preventing one HIV infection to be $229,800. These savings would approach an estimated $338,400 if all HIV patients sought care early and continued to receive treatment.

When adjusting for secondary infections, the costs savings were greater, and savings were lower in cases where HIV onset was forestalled rather than entirely prevented. – by Jen Byrne

Reference:

Schackman BR, et al. Abstract 1104. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 23-26, 2015; Seattle.

Disclosure: The researchers report no relevant financial disclosures.