Cost Analysis Of Comorbities: Evidence From A Hiv Plus Patients Cohort

Innovations in antiretroviral therapy (ART) have helped to prolong the life expectancy of HIV+ patients; however as patients age, they are likely to experience comorbidities that have substantial economic impact. Since costs related to any comorbidities among HIV+ patients are not sufficiently described in the literature, the present study aimed at determining the differential annual economic impact among the following groups of HIV+ patients: i) individuals not developing any comorbidity (HIV+); ii) population experiencing at least one comorbidity (HIV+ with comorbidities); and iii) subjects with comorbidities and a concomitant HCV infection (HIV/HCV). Consecutive cases of HIV+ patients at Fatebenefratelli Sacco Hospital in Milan were enrolled in an observational study (year 2015). The economic evaluation considered costs of ART, anti-HCV therapies, other drugs, examinations, in-hospital and day hospital events, consumed at both the hospital and territorial level. A preliminary analysis was completed. The sample (N=534) was predominantly male (78.8%) with a mean age of 49 years. Among the different groups of patients being followed, 37% were HIV+, 46% HIV+ with comorbidities and 17% HIV/HCV. No differences emerged between groups with respect to age and gender. The time from HIV diagnosis was significantly greater in the HIV/HCV group (21.6 years) compared to the HIV+ and HIV+ with comorbidities group (11.5 and 13.3 years respectively, p<0.05).HIV patients with comorbidities incurred costs up to 20% more than patients without comorbidities (p<0.05). Focusing on the population with two or more comorbidities, HIV/HCV patients required higher management costs than HIV (+7.58%, p<0.05). Healthcare providers managing HIV+ patients must be knowledgeable about the management of other comorbidities in the context of HIV. Treatment strategies that are able to decrease the burden of comorbidities in the long term should be preferred, freeing up economic resources to be reinvested in the clinical area.