Hartmut Krentz and colleagues measured the direct costs from 1995 to 2001 for all patients over the age of 15 who received any HIV care in southern Alberta. The authors found the mean cost per patient per month was $655 in 1995 and $1111 by 1998/99, when highly active antiretroviral therapy (HAART) was in wide use. The authors also found that costs remained relatively unchanged from 1998/99 to 2000/01 since increased costs of HAART were offset by decreased costs elsewhere (e.g., admissions to hospital, palliative home care).

The authors state that while their study predictably shows an increase in costs associated with the use of HAART as a result of an increased number and cost of drugs, it also appears that total costs for medical care have stabilized during the last 3 years. They state that their findings can help broadly predict future directions in costing trends and that various characteristics of the HIV epidemic, changing HAART guidelines and new technology will also influence future costs.

In a related commentary, Pedram Sendi and Amiram Gafni state that health care costs are only part of the equation and that gains in quality of life and productivity must also be considered. They warn that with finite health budgets and increasingly expensive programs, refinements are needed to generate more complete estimates of the cost-effectiveness of health services.

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Contact: Heike Hemlin
heike.hemlin@cma.ca
613-731-8610 x1703
Canadian Medical Association Journal
21-Jul-2003