Skip to main content
Top
Published in: PharmacoEconomics 7/2001

01-07-2001 | Leading Article

Highly Active Antiretroviral Therapy

Pharmacoeconomic Issues in the Management of HIV Infection

Authors: Dr Pedram Sendi, Andrew J. Palmer, Amiram Gafni, Manuel Battegay

Published in: PharmacoEconomics | Issue 7/2001

Login to get access

Abstract

The advent of highly active antiretroviral therapy (HAART), including protease inhibitors and/or non-nucleoside reverse transcriptase inhibitors, for the treatment of HIV infection has led to a dramatic decline of morbidity and mortality. The acquisition costs of HAART are substantial. However, these costs are partially offset by reduced inpatient care for opportunistic infections and other AIDS-related diseases. Furthermore, job productivity in patients infected with HIV is increased under HAART. In developed countries with a low unemployment rate, the discounted value of savings caused by increased productivity in earlier years exceeds the discounted value of later increases in costs resulting from morbidity. Therefore, HAART represents a very efficient treatment strategy that leads to overall cost savings when taking a societal perspective.
Literature
1.
go back to reference Egger M, Hirschel B, Francioli P, et al. Impact of new antiretroviral combination therapies in HIV infected patients in Switzerland: prospective multicentre study. Swiss HIV Cohort Study. BMJ 1997; 315: 1194–9PubMedCrossRef Egger M, Hirschel B, Francioli P, et al. Impact of new antiretroviral combination therapies in HIV infected patients in Switzerland: prospective multicentre study. Swiss HIV Cohort Study. BMJ 1997; 315: 1194–9PubMedCrossRef
2.
go back to reference Sendi PP, Bucher HC, Craig BA, et al. Estimating AIDS-free survival in a severely immunosuppressed asymptomatic HIV-infected population in the era of antiretroviral triple combination therapy. Swiss HIV Cohort Study. J Acquir Immune Defic Syndr Hum Retrovirol 1999; 20: 376–81CrossRef Sendi PP, Bucher HC, Craig BA, et al. Estimating AIDS-free survival in a severely immunosuppressed asymptomatic HIV-infected population in the era of antiretroviral triple combination therapy. Swiss HIV Cohort Study. J Acquir Immune Defic Syndr Hum Retrovirol 1999; 20: 376–81CrossRef
3.
go back to reference Hogg RS, Yip B, Kully C, et al. Improved survival among HIV-infected patients after initiation of triple-drug antiretroviral regimens. Can Med Assoc J 1999; 160: 659–65 Hogg RS, Yip B, Kully C, et al. Improved survival among HIV-infected patients after initiation of triple-drug antiretroviral regimens. Can Med Assoc J 1999; 160: 659–65
4.
go back to reference Carpenter CC, Cooper DA, Fisch lMA, et al. Antiretroviral therapy in adults: updated recommendations of the International AIDS Society-USA Panel. JAMA 2000; 283: 381–90PubMedCrossRef Carpenter CC, Cooper DA, Fisch lMA, et al. Antiretroviral therapy in adults: updated recommendations of the International AIDS Society-USA Panel. JAMA 2000; 283: 381–90PubMedCrossRef
5.
go back to reference Sendi PP, Bucher HC, Harr T, et al. Cost effectiveness of highly active antiretroviral therapy in HIV-infected patients. Swiss HIV Cohort Study. AIDS 1999; 13: 1115–22PubMedCrossRef Sendi PP, Bucher HC, Harr T, et al. Cost effectiveness of highly active antiretroviral therapy in HIV-infected patients. Swiss HIV Cohort Study. AIDS 1999; 13: 1115–22PubMedCrossRef
6.
go back to reference Moore RD. Cost effectiveness of combination HIV therapy: 3 years later. Pharmacoeconomics 2000; 17: 325–30PubMedCrossRef Moore RD. Cost effectiveness of combination HIV therapy: 3 years later. Pharmacoeconomics 2000; 17: 325–30PubMedCrossRef
7.
go back to reference Moore RD, Bartlett JG. Combination antiretroviral therapy in HIV infection: an economic perspective. Pharmacoeconomics 1996; 10: 109–13PubMedCrossRef Moore RD, Bartlett JG. Combination antiretroviral therapy in HIV infection: an economic perspective. Pharmacoeconomics 1996; 10: 109–13PubMedCrossRef
8.
go back to reference Cook J, Dasbach E, Coplan P, et al. Modeling the long-term outcomes and costs of HIV antiretroviral therapy using HIV RNA levels: application to a clinical trial. AIDS Res Hum Retroviruses 1999; 15: 499–508PubMedCrossRef Cook J, Dasbach E, Coplan P, et al. Modeling the long-term outcomes and costs of HIV antiretroviral therapy using HIV RNA levels: application to a clinical trial. AIDS Res Hum Retroviruses 1999; 15: 499–508PubMedCrossRef
9.
go back to reference Anis AH, Guh D, Hogg RS, et al. The cost effectiveness of antiretroviral regimens for the treatment of HIV/AIDS. Pharmacoeconomics 2000; 18: 393–404PubMedCrossRef Anis AH, Guh D, Hogg RS, et al. The cost effectiveness of antiretroviral regimens for the treatment of HIV/AIDS. Pharmacoeconomics 2000; 18: 393–404PubMedCrossRef
10.
go back to reference Caro JJ, O’Brien JA, Migliaccio-Walle K, et al. Economic analysis of initial HIV treatment: efavirenz- versus indinavir-containing triple therapy. Pharmacoeconomics 2001; 19: 95–104PubMedCrossRef Caro JJ, O’Brien JA, Migliaccio-Walle K, et al. Economic analysis of initial HIV treatment: efavirenz- versus indinavir-containing triple therapy. Pharmacoeconomics 2001; 19: 95–104PubMedCrossRef
11.
go back to reference Gebo KA, Chaisson RE, Folkemer JG, et al. Costs of HIV medical care in the era of highly active antiretroviral therapy. AIDS 1999; 13: 963–9PubMedCrossRef Gebo KA, Chaisson RE, Folkemer JG, et al. Costs of HIV medical care in the era of highly active antiretroviral therapy. AIDS 1999; 13: 963–9PubMedCrossRef
12.
go back to reference Mole L, Ockrim K, Holodniy M. Decreased medical expenditures for care of HIV-seropositive patients: the impact of highly active antiretroviral therapy at a US Veterans Affairs Medical Center. Pharmacoeconomics 1999; 16: 307–15PubMedCrossRef Mole L, Ockrim K, Holodniy M. Decreased medical expenditures for care of HIV-seropositive patients: the impact of highly active antiretroviral therapy at a US Veterans Affairs Medical Center. Pharmacoeconomics 1999; 16: 307–15PubMedCrossRef
13.
go back to reference Baum SE, Morris JT, Gibbons RV, et al. Reduction in human immunodeficiency virus patient hospitalizations and nontraumatic mortality after adoption of highly active antiretroviral therapy. Mil Med 1999; 164: 609–12PubMed Baum SE, Morris JT, Gibbons RV, et al. Reduction in human immunodeficiency virus patient hospitalizations and nontraumatic mortality after adoption of highly active antiretroviral therapy. Mil Med 1999; 164: 609–12PubMed
14.
go back to reference Zinkernagel C, Ledergerber B, Battegay M, et al. Quality of life in asymptomatic patients with early HIV infection initiating antiretroviral therapy. Swiss HIV Cohort Study. AIDS 1999; 13: 1587–9PubMedCrossRef Zinkernagel C, Ledergerber B, Battegay M, et al. Quality of life in asymptomatic patients with early HIV infection initiating antiretroviral therapy. Swiss HIV Cohort Study. AIDS 1999; 13: 1587–9PubMedCrossRef
15.
go back to reference Krahn M, Gafni A. Discounting in the economic evaluation of health care interventions. Med Care 1993; 31: 403–18PubMedCrossRef Krahn M, Gafni A. Discounting in the economic evaluation of health care interventions. Med Care 1993; 31: 403–18PubMedCrossRef
16.
go back to reference Meltzer D. Accounting for future costs in medical cost-effectiveness analysis. J Health Econ 1997; 16: 33–64PubMedCrossRef Meltzer D. Accounting for future costs in medical cost-effectiveness analysis. J Health Econ 1997; 16: 33–64PubMedCrossRef
17.
go back to reference Meltzer D, Egleston B, Stoffel D, et al. Effect of future costs on cost-effectiveness of medical interventions among young adults: the example of intensive therapy for type 1 diabetes mellitus. Med Care 2000; 38 (6): 679–85PubMedCrossRef Meltzer D, Egleston B, Stoffel D, et al. Effect of future costs on cost-effectiveness of medical interventions among young adults: the example of intensive therapy for type 1 diabetes mellitus. Med Care 2000; 38 (6): 679–85PubMedCrossRef
18.
go back to reference Birch S, Gafni A. Cost effectiveness/utility analyses: do current decision rules lead us to where we want to be? J Health Econ 1992; 11: 279–96PubMedCrossRef Birch S, Gafni A. Cost effectiveness/utility analyses: do current decision rules lead us to where we want to be? J Health Econ 1992; 11: 279–96PubMedCrossRef
19.
go back to reference Weinstein MC. From cost-effectiveness ratio to resource allocation, where to draw the line? In: Sloan FA, editor. Valuing health care: costs, benefits and effectiveness of pharmaceuticals and other medical technologies. Cambridge: Cambridge University Press, 1995: 77–9CrossRef Weinstein MC. From cost-effectiveness ratio to resource allocation, where to draw the line? In: Sloan FA, editor. Valuing health care: costs, benefits and effectiveness of pharmaceuticals and other medical technologies. Cambridge: Cambridge University Press, 1995: 77–9CrossRef
20.
go back to reference Birch S, Gafni A. Cost effectiveness ratios: in a league of their own. Health Policy 1994; 28: 133–41PubMedCrossRef Birch S, Gafni A. Cost effectiveness ratios: in a league of their own. Health Policy 1994; 28: 133–41PubMedCrossRef
21.
go back to reference Zwart-van Rijkom JE, Leufkens HG, Busschbach JJ, et al. Differences in attitudes, knowledge and use of economic evaluations in decision-making in The Netherlands: the Dutch results from the EUROMET Project. Pharmacoeconomics 2000; 18: 149–60PubMedCrossRef Zwart-van Rijkom JE, Leufkens HG, Busschbach JJ, et al. Differences in attitudes, knowledge and use of economic evaluations in decision-making in The Netherlands: the Dutch results from the EUROMET Project. Pharmacoeconomics 2000; 18: 149–60PubMedCrossRef
Metadata
Title
Highly Active Antiretroviral Therapy
Pharmacoeconomic Issues in the Management of HIV Infection
Authors
Dr Pedram Sendi
Andrew J. Palmer
Amiram Gafni
Manuel Battegay
Publication date
01-07-2001
Publisher
Springer International Publishing
Published in
PharmacoEconomics / Issue 7/2001
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200119070-00001

Other articles of this Issue 7/2001

PharmacoEconomics 7/2001 Go to the issue