Evaluation of drug use and cost of hospital care for aids patients between 1990 and 1994.
- 36 Downloads
This study was designed to evaluate drug use and drug costs of treatment of 1112 AIDS patients at the Infectious Diseases Unitat F. Houphouét Boigny Hospital in Marseilles, France, between January 1, 1990 and December 31, 1994. All drug expenditures directly or indirectly related to AIDS treatment were recorded for both inpatients and outpatients. There were 1952 hospital stays. For each stay baseline characteristics including age, sex, risk factors, costs, and duration of hospitalization were noted. Patients were mainly young male drug addicts around thirty years of age. Reason for admission was also noted. The overall number of admissions per year has decreased since 1991 probably due to development of outpatient care. The number of stays per patient per year has decreased since 1993 because of the use of more appropriate therapeutic and prophylactic protocols. The number of drugs used was high increasing from 750 in 1990 to 868 in 1994. Cost of treatment doubled between 1 1994 due to the introduction of many expensive new drugs. Closer analysis showed that the greatest increase in expenditure involved 'antibiotic/antiviral', 'psychiatry/neurology' and 'specialized therapy'. Although not frequently prescribed, costly drugs such as immunoglobulins, hematopoietic growth factors, and parenteral nutrition solutions accounted for a high proportion of total costs. Since AZT, ddI and ddC were used mainly for outpatient treatment, their cost was low in inpatients. Cytomegalovirus‐related retinitis, tuberculosis, and multiple infections were cost‐intensive complications. The increasing number of cytomegalovirus infections underlines the need for cost evaluation and surveillance of this complication. This study demonstrates that cost of treating AIDS patients is rising due to the use of more and costlier drugs. This finding underlines the need to evaluate and compare new therapeutic modalities in terms of cost effectiveness.
Unable to display preview. Download preview PDF.
- 1.Bennett CL, Cvitanic M, Pascal A. The cost of AIDS in Los Angeles. J Acquir Immune Defic Syndr 1991;4(2):197–203.Google Scholar
- 2.Boulay F. Le coût du SIDA aux Etats-Unis: chiffres et implica-tions. Lettre Infect 1989;IV(7):243–8.Google Scholar
- 3.Cavaignac L, Geoffard PY, Tortay I. La disparité des dépenses médicales directes. Direction des hôpitaux, Mission SIDA, Ministère de la santé et de l'action humanitaire, SIDA et hôpital, DMI 2: un système d'information centré sur les patients, 1995:61–5.Google Scholar
- 4.Chan I, Neaton JD, Saravolatz LD, Crane LR, Osterberger J. Frequencies of opportunistic diseases prior to death among HIV-infected persons. AIDS 1995;9:1145–51.Google Scholar
- 5.Choukroun G, Lons Danic D, Veninger G, Emam K, Rasle A, Picard C, Sobel A. Coûts des soins hospitaliers liés au SIDA à l'Hôpital Henri Mondor. Ann Med Interne 1988;139(7):505–7.Google Scholar
- 6.Drummond MF. The economic impact of AIDS. AIDS CARE 1989;1(2):216–8.Google Scholar
- 7.Essai Delta. Les résultats. Septembre 1995.Google Scholar
- 8.Fournier I, DMI 2: une nouvelle photographie des patients suivis à l'hôpital. Journal du Sida 1995;77:10–12.Google Scholar
- 9.Hardy AM, Rauch K, Echenberg D, Morgan WM, Curran JW. The economic impact of the first 10 000 cases of Acquired Immunodeficiency Syndrome in the United States. JAMA 1986;255(2):209–11.Google Scholar
- 10.Holland GN, Sisen RF, Jatulis DE et al. Survival of patients with the acquired immune deficiency syndrome after develop-ment of cytomegalovirus retinopathy. Ophtalmology 1990;97:204–11.Google Scholar
- 11.Scitovsky AA, Cline M, Lee PR. Medical care costs of patients with AIDS in San Francisco. JAMA 1986;256(22): 3103–6.Google Scholar
- 12.Seage GR, Landers S, Barry MA, Groopman J, Lamb GA, Epstein AM. Medical care cost of AIDS in Massachusetts. JAMA 1986;256(22):3107–9.Google Scholar
- 13.Spira A. Dynamique de l'épidémie chez les hétérosexuels: un état de la question. Journal du Sida 1995;70-71:14–5.Google Scholar
- 14.Tortay I. Nature et coût des consommations de médicaments liés aux séjours hospitaliers de patients infectés par le VIH. SIDA et hôpital, DMI 2: un système d'information centré sur les patients,1995;49–60.Google Scholar
- 15.World Heath Organisation, Weekly Epidemiological Record, Geneva, December 1995;no50:353–60.Google Scholar