Direct medical cost of HIV/AIDS care at Sikhoraphum Hospital, Surin Province
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Abstract
Introduction: HIV-infected patients may access care for the first time at different stages of their HIV infection. Medical cost of these patients may vary depending upon the level of CD4 count. Objective: This study aimed to analyze direct medical cost during the first and second year of treatment of patients who were newly diagnosed HIV infection between 2011 and 2013 at Sikhoraphum Hospital, Surin Province. Method: Cost analysis was performed from health care provider perspective using micro-costing technique. The direct medical care costs were stratified according to initial CD4 cell count including 1) CD4<50 cells/mm3, 2) CD4 51-200 cells/mm3, 3) CD4 201-350 cells/mm3, and 4) CD4> 350 cells/mm3. A retrospective analysis of outpatient and inpatient records from both electronic and paper documentation was performed to obtain data of resource uses per visit or per hospitalization. Cost components for outpatient care included antiretroviral (ARV) drugs, prophylactic drugs for opportunistic infections, other drugs, laboratory test, radiological investigation, diagnostic test, and medical care cost. For inpatient care, medical supplies, blood product transfusion, and room/food service were also included. Annual costs were calculated in 2015 value. Results: Total number of sample was 55 patients. Sixty percent of patients were female and average age was 40±8 years. More than 70% of patients had initial CD4 cell count less than 200 cells/mm3. Antiretroviral regimen which most of patients received as first line was GPO-VIR Z® (74.5%), followed by GPO-VIR S® (12.7%). Patients with comorbidity of tuberculosis received alternative ARV regimens. Median annual cost during the first year among patients with initial CD4 cell count less than 50 cells/mm3 was 15,075.4 baht/person/year and was higher than those of other groups. Median annual cost during the second year of treatment was lower than those of the first year in all patient groups. Average annual cost in the second year among patients with initial CD4 cell count less than 50 cells/mm3 was 13,149.7 baht/person/year. Outpatient cost accounted for greater than 60% of all costs and major cost of outpatient care wasdrug cost. Conclusion: Direct medical cost of treatment for patients newly diagnosed HIV infection who received care at Sikhoraphum Hospital, Surin Province between 2011 and 2013, and initial CD4 cell count less than 50 cells/mm3 was higher than the groups of patients with higher level of CD4 cell count, especially in the first year of treatment.
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References
April MD, Wood R, Bethany K, et.al. The Survival Benefits of Antiretroviral Therapy in South Africa. J Infect Dis2014; 209: 491–9.
Boonna N. Cost and Benefit Evaluation of HIV/AIDS infected patients Treated by Antiretroviral Drug of Lampang Hospital. [Master’s thesis]. Chiangmai: Chiangmai University; 2005.
Boubouchairopoulou N, Athanasakis K, Chini M, Mangafas N, Lazanas MK, Kyriopoulos JE. Estimation of the Direct Cost of HIV-Infected Patients in Greece on an Annual Basis. Value Health Reg Issues2014; 4C: 82–86.
Drug Medical Supply Information Center. Reference price database [Online] 2015 cited 2015 November 20]. Availablefrom: http://dmsic.moph.go.th/dmsic/index.php?p=1&type=3&s=3&id=drug_normal.
Farahani M, Vable A, Lebelonyane R, et al. Outcomes of the Botswana national HIV/AIDS treatment programme from 2002 to 2010: a longitudinal analysis. Lancet Glob Health 2014; 2: 44–50.
Krentz HB and Gill MJ. The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year Period. AIDS Res Treat 2012:1–8.
Kulsomboon W, Thanviriyakul S, Pinyowiwat V. The Study on Cost-Benefit Analysis of Including Triple Antiretroviral Therapy into the Benefit Package of the Universal Health Coverage in Thailand (Research project); 2003.
Loongban S. Discrepancy of treatment cost of HIV patients before and after receiving triple Antiretroviralthreapy in Saraburi Province [Master’sthesis]. Bangkok: Chulalongkorn University; 2003.
Ongwandee S, Lertpiriyasuwat C, Lolekha R et al. Thailand National Guidelines on HIV/AIDS Treatment and Prevention 2014. 1sted. Bangkok: Agricultural cooperative printing demonstrations of Thai Ltd; 2014.
Perelman J, Alves J, Miranda AC, et.al. Direct treatment costs of HIV/AIDS in Portugal. Rev Saude Publica 2013; 47(5): 865–72.
Phanuphak P, Leechawengwongs M, Siraprapasiri T, et al. Thailand National Guidelines on HIV/AIDS Treatment and Prevention 2010. 1sted. Bangkok: Agricultural cooperative printing demonstrations of Thai Ltd; 2010.
Riewpaiboon A. Standard Cost Lists for Health Technology Assessment (Research Project). 2011.
Rosen S, Long L, Sanne I. The outcomes and outpatient costs of different models of antiretroviral treatment delivery in South Africa. Trop Med Int Health2008; 13(8): 1005–15.
Sloan CE, Champenois K, Choisy P, et al. Newer drugs and earlier treatment: impact on lifetime cost of care for HIV-infected adults. AIDS 2012; 26: 45–56.
Sirinirund P, Siraprapasiri T, Nimvorapun W. Meeting of the National Committee for HIV/AIDS Prevention and Control Strategy FY 2012-2013. 1sted. Bangkok: 617-company-limited; 2013.
ZhouF, Kominski GF, Qian HZ, et.al. Expenditures for the care of HIV-infected patients in rural areas in China’s antiretroviral therapy programs. BMC Medicine 2011; 9(6): 1–10.