TITLE

Cost effectiveness of prophylaxis for opportunistic infections in AIDS. An overview and methodological discussion

AUTHOR(S)
Freedberg, K.A.; Paltiel, A.D.
PUB. DATE
August 1998
SOURCE
PharmacoEconomics;1998, Vol. 14 Issue 2, p165
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Dramatic progress has recently been made in defining the pathogenesis and treatment of HIV infection. For the first time in the history of the AIDS epidemic, clinicians have at their disposal an understanding of the replication kinetics of HIV, reliable assays to measure viral load, an increasing number of effective agents to suppress viral replication and to reverse the process of immune system destruction, and a range of options for the treatment and prophylaxis of most of the major opportunistic infections in HIV disease. These remarkable advances are not without their costs, however. New antiretroviral therapies and opportunistic infection prophylaxis regimens impose considerable financial strain on public and private budgets for HIV patient care. They force decision-makers to confront a variety of competing considerations, including issues of length and quality of life, the risks of adverse effects and toxicities, and the dangers of promoting resistance. Questions regarding the continued appropriateness and efficiency of opportunistic infection prevention have prompted increased interest in studies of the cost effectiveness of HIV patient care. In this article, we reviewed the literature on the economic evaluation of prophylaxis for HIV-related complications. Section 1 provides background on recent scientific and clinical advances. Section 2 reviews the state-of-the-art understanding of the cost effectiveness of prophylaxis against specific opportunistic infections. Section 3 broadens the discussion to consider the more general question of optimal allocation of prophylaxis resources across competing opportunistic infections. In Section 4, we briefly examined the influence of cost-effectiveness evaluations on the development and refinement of clinical guidelines for HIV-related opportunistic infection prevention in the US. Section 5 presents some of the methodological challenges that arise in applying the methods of cost-effectiveness analysis to the particular case of opportunistic infection prevention in AIDS. We close, in Section 6, with a comment on directions for further research.
ACCESSION #
9526718

 

Related Articles

  • Analysis of Michigan Medicaid Costs to Treat HIV Infection. Solomon, David J.; Hogan, Andrew J.; Bouknight, Reynard A.; Solomon, Carolyn T. // Public Health Reports;Sep/Oct89, Vol. 104 Issue 5, p416 

    To obtain better understanding of the nature and cost of health care related to human immunodeficiency virus (HIV) infection, medical payment records were analyzed for 204 men, women, and children older than 60 months who had indications of HIV infection. The records were those of Michigan...

  • Coping with the cost burdens of illness: Combining qualitative and quantitative methods in longitudinal, household research. Goudge, Jane; Gumede, Tebogo; Gilson, Lucy; Russell, Steve; Tollman, Stephen M.; Mills, Anne // Scandinavian Journal of Public Health;May2007 Supplement 69, Vol. 35 Issue s69, p181 

    Over the last 10-15 years, poor African households have had to cope with the burden of increased levels of chronic illness such as HIV/AIDS. How do these households cope with the cost burdens of ill health and healthcare, and has this burden further impoverished them? What policy responses might...

  • State AIDS Drug Assistance Programs Continue to Face Difficult Funding Challenges; 11 States Close Enrollment, 9 Have Waiting Lists to Receive HIV Drugs; Wide Variation in Access to HIV...  // Ascribe Newswire: Medicine;5/20/2004, p165 

    Despite a 9 percent increase in the overall AIDS Drug Assistance Programs (ADAPs) budget in the U.S. between fiscal year 2002 and 2003, an increasing number of people living longer with HIV/AIDS, the rising costs of HIV medications, and continuing fiscal pressures at the Federal and state levels...

  • HIV patients live years after diagnosis.  // Gay & Lesbian Times;11/16/2006, Issue 986, p28 

    The article reports on the results of a research which show that an American diagnosed with the AIDS virus can expect to live for about 24 years on average. The research also shows that the cost of health care throughout those decades is more than $600,000. Bruce Schackman is the lead author of...

  • Financing Health Care for Persons with HIV Infection: Guidelines for State Action. Fox, Daniel M. // American Journal of Law & Medicine;1990, Vol. 16 Issue 1/2, p223 

    Promises of confidentiality of HIV-related medical records and protection from discrimination based on HIV seropositivity are two of the legislative inducements state governments have offered to encourage voluntary HIV testing. Yet neither can be granted without impact on others whose interests...

  • Health Economics in HIV Disease: A Review of the European Literature. Youle, M.; Trueman, P.; Simpson, K. // PharmacoEconomics;1999 Supplement 1, Vol. 15 Issue 5, p1 

    The costs of providing healthcare resources for patients with HIV disease have continued to rise during the last 2 decades since the first outbreak of AIDS. Although new and effective therapies have become available during this time, and are increasingly being used, outcome measures for, and the...

  • Building African AIDS Care from the Ground Up.  // Annals of Internal Medicine;7/15/2003, Vol. 139 Issue 2, p157 

    The epicenter of AIDS activity in the early 1980s was San Francisco General Hospital, where Merle Sande, MD, was chief of medicine. Within the next decade, physicians in the United States learned how to treat HIV infection and AIDS as pharmaceutical companies launched drugs that controlled the...

  • Option A or B the best route?  // PharmacoEconomics & Outcomes News;8/20/2011, Issue 635, p5 

    The article discusses a study which examined the impact on costs and mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) for two treatment options in Tanzania.

  • Cost of treating HIV remains high; Louisiana feels the pain. Daugherty, Christi // New Orleans CityBusiness (1994 to 2008);12/14/98, Vol. 19 Issue 24, p25 

    Reports on the rise of drug therapy costs for HIV infection in Louisiana. Insurance coverage of patients with HIV; Average expenses of patients with HIV or AIDS; Reasons for the increase of HIV drug therapy costs; Effects of drug therapy to people with HIV.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics