PMID- 32011956
OWN - NLM
STAT- MEDLINE
DCOM- 20201105
LR  - 20240403
IS  - 2376-1032 (Electronic)
IS  - 2376-0540 (Print)
IS  - 2376-0540 (Linking)
VI  - 26
IP  - 2
DP  - 2020 Feb
TI  - Estimating HIV Management and Comorbidity Costs Among Aging HIV Patients in the 
      United States: A Systematic Review.
PG  - 104-116
LID - 10.18553/jmcp.2020.26.2.104 [doi]
AB  - 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 state costs ranging from $1,192 for patients with CD4 > 
      500 cells/mm(3) to $2,873 for patients with CD4 < 50 cells/mm(3). Event costs for 
      AEs ranged from $0 for headache, pain, vomiting, and lipodystrophy to $31,545 for 
      myocardial infarction. The mean monthly per-patient costs for CVD management, CKD 
      management, and osteoporosis were $5,898, $6,108, and $4,365, respectively. 
      Improvements in life expectancy, approaching that of the general population in 
      2018, are projected to increase ART-related and AE costs by 35.4% and comorbidity 
      costs by 175.8% compared with estimated costs with HIV life expectancy observed 
      in 1996. CONCLUSIONS: This study identified and summarized holistic cost 
      estimates appropriate for use within U.S. HIV cost-effectiveness analyses and 
      demonstrates an increasing contribution of comorbidity outcomes, primarily 
      associated with aging in addition to long-term treatment with ART, not typically 
      evaluated in contemporary HIV cost-effectiveness analyses. DISCLOSURES: This 
      analysis was sponsored by ViiV Healthcare, which had no role in the analyses and 
      interpretation of study results. Ward, Sugrue, Hayward, and McEwan are employees 
      of HEOR Ltd, which received funding from ViiV Healthcare to conduct this study. 
      Anderson is an employee of GlaxoSmithKline and holds shares in the company. 
      Punekar and Oglesby are employees of ViiV Healthcare and hold shares in 
      GlaxoSmithKline. Lopes was employed by ViiV Healthcare at the time of the study 
      and holds shares in GlaxoSmithKline.
FAU - Ward, Thomas
AU  - Ward T
AD  - HEOR Ltd, Cardiff, United Kingdom.
FAU - Sugrue, Daniel
AU  - Sugrue D
AD  - HEOR Ltd, Cardiff, United Kingdom.
FAU - Hayward, Olivia
AU  - Hayward O
AD  - HEOR Ltd, Cardiff, United Kingdom.
FAU - McEwan, Phil
AU  - McEwan P
AD  - HEOR Ltd, Cardiff, United Kingdom.
FAU - Anderson, Sarah-Jane
AU  - Anderson SJ
AD  - ViiV Healthcare, Brentford, United Kingdom.
FAU - Lopes, Sara
AU  - Lopes S
AD  - ViiV Healthcare, Brentford, United Kingdom.
FAU - Punekar, Yogesh
AU  - Punekar Y
AD  - ViiV Healthcare, Brentford, United Kingdom.
FAU - Oglesby, Alan
AU  - Oglesby A
AD  - ViiV Healthcare, Research Triangle, North Carolina.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
PL  - United States
TA  - J Manag Care Spec Pharm
JT  - Journal of managed care & specialty pharmacy
JID - 101644425
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Anti-HIV Agents/*administration & dosage/economics
MH  - CD4 Lymphocyte Count
MH  - Comorbidity
MH  - Cost-Benefit Analysis
MH  - HIV Infections/*drug therapy/economics
MH  - Health Care Costs/*statistics & numerical data
MH  - Humans
MH  - Life Expectancy
MH  - United States
PMC - PMC10391104
COIS- This analysis was sponsored by ViiV Healthcare, which had no role in the analyses 
      and interpretation of study results. Ward, Sugrue, Hayward, and McEwan are 
      employees of HEOR Ltd, which received funding from ViiV Healthcare to conduct 
      this study. Anderson is an employee of GlaxoSmithKline and holds shares in the 
      company. Punekar and Oglesby are employees of ViiV Healthcare and hold shares in 
      GlaxoSmithKline. Lopes was employed by ViiV Healthcare at the time of the study 
      and holds shares in GlaxoSmithKline.
EDAT- 2020/02/06 06:00
MHDA- 2020/11/06 06:00
PMCR- 2020/02/01
CRDT- 2020/02/04 06:00
PHST- 2020/02/04 06:00 [entrez]
PHST- 2020/02/06 06:00 [pubmed]
PHST- 2020/11/06 06:00 [medline]
PHST- 2020/02/01 00:00 [pmc-release]
AID - 10.18553/jmcp.2020.26.2.104 [doi]
PST - ppublish
SO  - J Manag Care Spec Pharm. 2020 Feb;26(2):104-116. doi: 
      10.18553/jmcp.2020.26.2.104.