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Med adherence leads to health care cost savings
Results apply in settings with cheaper ART drugs
HIV patients in international settings where cheaper drugs are available and who are more adherent to their antiretroviral treatment cost less overall to treat than do patients who are less adherent, a new study shows.
HIV- infected patients who are highly adherent have lower direct health care costs, says Jean B. Nachega, MD, PhD, MPH, an associate scientist in international health with Johns Hopkins University in Baltimore, MD.
"They saved a median $85 monthly per patient," Nachega says. "That was mainly due to their taking their medicine correctly, so they were less likely to be sick and hospitalized."
The study looked specifically at 6,833 HIV-infected adults who started antiretroviral therapy (ART) between 2000 and 2006.1
"In South Africa, HIV medicine is free of charge to patients, and everyone has access to treatment," Nachega notes.
The study enrolled HIV patients who were enrolled in Aid for AIDS, an HIV/AIDS managed care program. Investigators reviewed medical cost data from claims from physicians, hospitals, and laboratories.
"We used information from that insurance company to access the cost of the clinic and to see what was used from outpatient care, medicine, and so on," Nachega says.
ART costs for the study's cohort accounted for 13% of total costs, a relatively small proportion that was due to the lower drug prices negotiated through international access programs.
Regardless of ART drug costs, the study confirms earlier research that better ART adherence results in lower hospitalization and medical care utilization.
"Our take home message is that health providers or states should invest money in adherence and not only do it but do it proactively," Nachega says. "We also need a training program to monitor and identify people with problems to help them before it's too late and their drugs fail and drug resistance emerges."