Cost distribution of highly active antiretroviral therapy

Abstract

The efficacy of highly active antiretroviral therapy (HAART) implies a high pharmaceutical cost. Deficient patient adhesion to therapy means that not all individuals benefit from treatment, while some patients are in non-advanced stages of the disease where such management may not be necessary. A study is made of the cost distribution of HAART. An analysis was made of 199 HIV-infected adults subjected to HAART at least once during 2001. The medication history was used to calculate the cost of HAART in the global group, in the patients who abandoned treatment (group A), in the group in which viral load was not controlled (group B), and in the patients starting with or reaching a CD4+ count > 500 cells/mm3 (groups C1 and C2, respectively). The global annual cost of HAART (discounting returned medication) was 961,720 Euro (21.3% of the global hospital pharmacological expenditure), group A accounting for 6.3%, group B 14.26%, and subgroups C1 and C2 for 12.1 and 8.1, respectively. In our center, almost 40% of antiretroviral drug expenditure may be considered of little use.