Estimating HIV Management and Comorbidity Costs Among Aging HIV Patients in the United States: A Systematic Review

作者：Thomas Ward, Daniel Sugrue, Olivia Hayward, Phil McEwan, Sarah‐Jane Anderson, Sara Lopes, Yogesh Punekar, Alan Oglesby · 发表于：Journal of Managed Care & Specialty Pharmacy · 年份：2020 · DOI：10.18553/jmcp.2020.26.2.104 · 被引用次数：27 · 研究领域：HIV-related health complications and treatments、HIV/AIDS Research and Interventions、HIV/AIDS drug development and treatment

BACKGROUND: As life expectancy of patients infected with human immunodeficiency virus (HIV) approaches that of the general population, the composition of HIV management costs is likely to change. OBJECTIVES: To (a) review treatment and disease management costs in HIV, including costs of adverse events (AEs) related to antiretroviral therapy (ART) and long-term toxicities, and (b) explore the evolving cost drivers. METHODS: A targeted literature review between January 2012 and November 2017 was conducted using PubMed and major conferences. Articles reporting U.S. costs of HIV management, acquired immunodeficiency syndrome (AIDS)-defining events, end of life care, and ART-associated comorbidities such as cardiovascular disease (CVD), chronic kidney disease (CKD), and osteoporosis were included. All costs were inflated to 2017 U.S. dollars. A Markov model-based analysis was conducted to estimate the effect of increased life expectancy on costs associated with HIV treatment and management. RESULTS: 22 studies describing HIV costs in the United States were identified, comprising 16 cost-effectiveness analysis studies, 5 retrospective analyses of health care utilization, and 1 cost analysis in a resource-limited setting. Management costs per patient per month, including routine care costs (on/off ART), non-HIV medication, opportunistic infection prophylaxis, inpatient utilization, outpatient utilization, and emergency department utilization were reported as CD4+ cell-based health s...