Estimation of Lifetime Costs Among Insured Persons with HIV in the United States.

IF 2 Q2 ECONOMICS

PharmacoEconomics Open Pub Date : 2025-06-09 DOI:10.1007/s41669-025-00584-0

Joshua P Cohen, Vamshi Ruthwik Anupindi, Riddhi Doshi, Jason Yeaw, Xiaoyu Zhou, Mary J Christoph, Megan Chen, Paresh Chaudhari, Cassidy Trom, Woodie Zachry

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引用次数: 0

Abstract

Background/objective: With recent advances in human immunodeficiency virus (HIV) management and prevention, it is critical to understand the lifetime costs (LTC) of HIV. The objective of the study was to evaluate all-cause LTC, annual costs and healthcare resource utilization (HCRU) among persons with HIV (PWH) versus a matched non-HIV cohort in the United States (US).

Methods: This observational study included persons (≥ 18 years) with an HIV diagnosis, antiretroviral treatment (ART), and continuous enrollment (CE) within each year (2018-2023) in the PWH cohort, and with no HIV diagnosis/ART and CE in the non-HIV cohort, identified using a US commercial claims database (IQVIA PharMetrics^® Plus). Cohorts were matched 1:3 on age, sex, geographic region, and health plan. Undiscounted LTC, discounted LTC (95% confidence interval [CI]) and annual costs were computed in 2022 US dollars (USD) for ages 18-75 years. Annual inpatient, outpatient, emergency room, and outpatient pharmacy utilization and costs were compared.

Results: Person counts ranged from 45,465 to 54,530 in the PWH cohort and 136,395 to 163,590 in the non-HIV cohort from 2018 to 2023. Mean undiscounted LTC were $2,895,020 (CI 2,847,453-2,947,867) and $482,522 (CI 453,114-513,44) for PWH and non-HIV cohorts, respectively, with an incremental cost difference of $2,412,498 (CI 2,354,674-2,474,024). Mean discounted LTC were $1,299,210 (CI 1,279,397-1,321,458) and $181,481 (CI 169,392-194,036) for PWH and non-HIV cohorts, respectively, with an incremental cost difference of $1,117,729 (CI 1,093,606-1,143,350). Mean annual total costs were six to seven times higher among PWH than the non-HIV cohort each year; with higher costs among older persons. HCRU was higher among PWH.

Conclusions: Among a sample of primarily commercially insured US adults, HIV conferred an estimated incremental LTC difference of over $2.4 million (undiscounted) and $1.1 million (discounted), with annual costs being six to seven times higher for PWH compared to non-HIV persons.

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估计在美国艾滋病毒感染者的终身费用。

背景/目的：随着人类免疫缺陷病毒（HIV）管理和预防的最新进展，了解HIV的终生成本（LTC）至关重要。本研究的目的是评估美国HIV感染者（PWH）与非HIV感染者（US）的全因LTC、年度成本和医疗资源利用率（HCRU）。方法：本观察性研究纳入了每年（2018-2023年）接受HIV诊断、抗逆转录病毒治疗（ART）和连续入组（CE）的患者（≥18岁），在PWH队列中，使用美国商业索赔数据库（IQVIA PharMetrics®Plus）确定无HIV诊断/ART和CE的非HIV队列。年龄、性别、地理区域和健康计划按1:3匹配。未贴现LTC、贴现LTC（95%置信区间[CI]）和年成本以2022美元（USD）计算，年龄为18-75岁。比较年度住院、门诊、急诊室和门诊药房的使用和费用。结果：2018年至2023年，PWH队列的人数为45,465至54,530人，非hiv队列的人数为136,395至163,590人。PWH组和非hiv组的平均未贴现LTC分别为2,895,020美元（CI 2,847,453-2,947,867）和482,522美元（CI 453,114-513,44），增量成本差异为2,412,498美元（CI 2,354,674-2,474,024）。PWH组和非hiv组的平均折扣LTC分别为1,299,210美元（CI 1,279,397-1,321,458）和181,481美元（CI 169,392-194,036），增量成本差异为1,117,729美元（CI 1,093,606-1,143,350）。每年PWH组的平均年总费用比非hiv组高6至7倍；老年人的费用更高。PWH组HCRU较高。结论：在主要商业保险的美国成年人样本中，艾滋病毒导致的估计增量LTC差异超过240万美元（未折扣）和110万美元（折扣），与非艾滋病毒感染者相比，PWH的年成本高出6至7倍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PharmacoEconomics Open Multiple-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.