Important note: Information in this article was accurate in 2001. The state of the art may have changed since the publication date.
Associated Press - Wednesday, March 14, 2001
Jeff Donn, Associated Press Writer
In a separate study, researchers calculated that AIDS drugs cost about $20,000 in the United States for each year of a patient's extended life -making them a better value than many common treatments for conditions like high cholesterol, breast cancer and heart attacks.
The two cost-effectiveness studies, reported in Thursday's New England Journal of Medicine, are likely to add to the fierce debate over how to expand access to HIV drugs for poor people and nations.
Christine Nadori, a medical officer at the international relief agency Doctors Without Borders, said some nations with relatively strong health systems could gain similar economic benefits. "I think this should spur efforts to broaden access," she said.
AIDS cocktails -a combination of protease inhibitors and other drugs -have come into general use over the past five years or so, transforming the AIDS virus from a death sentence into a treatable condition.
The cost per patient typically ranges from $10,000 to $15,000 a year in the United States, putting the drugs beyond the reach of many people without adequate insurance. And many infected people go untreated in sub-Saharan Africa and nations elsewhere that cannot afford even discounted drugs.
In its study, the RAND research institute in Santa Monica, Calif., coordinated the largest examination ever of the economics of those drugs.
The researchers interviewed 2,864 HIV patients.
Between 1996 and 1998, the patients' average annual medical costs slipped from $20,300 to $18,300, thanks to reduced hospital time.
"Even at these high prices, these drug therapies are a good buy," said Dr. Samuel Bozzette, who led the study.
The researchers warned that the rise of drug-resistant strains of HIV and toxic effects from the drugs could drive up hospital costs in the future.
In the second study, researchers calculated that each additional healthy year in a patient's life costs between $13,000 and $23,000; researchers often use $50,000 as the upper limit for cost-effectiveness.
Life expectancy rose an average of 18 months to three years.
"There aren't a lot of things that we treat that are a lot more cost-effective than this," said Dr. Kenneth Freedberg, who led the study at Massachusetts General Hospital in Boston.
"That's one of the things we've argued for many years now," said Jeff Trewhitt, a spokesman for the Pharmaceutical Research and Manufacturers of America. "Generally, pharmaceuticals are going to be cheaper than surgery, hospitalization and nursing home confinement."
Dr. Robert Steinbrook, a deputy editor at the New England Journal of Medicine, said in an accompanying editorial that U.S. government health programs should negotiate with drug companies for lower prices and expand coverage for the poor.
Seth Amgott, a spokesman for the international aid group Oxfam, also said drug companies should cut prices.
"A large part of the world is so poor that economic analysis won't justify something we all know is right, which is providing treatment to keep people alive," he said.
On the Net:
Joint United Nations Program on HIV/AIDS: http://www.unaids.org List of FDA-approved HIV drugs: http://www.fda.gov/oashi/aids/stat -app.html
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