AIDSWEEKLY Plus, Monday, 20 October 1997
Daniel J. DeNoon, Senior Editor
If anti-HIV therapy is effective, it buys one or more extra years of life for about $8000 per year.
The figures come from an economic model developed by researchers at Glaxo-Wellcome Inc. to project lifetime treatment costs for people with HIV.
When the model was tested using data from a hypothetical cohort from the Multicenter AIDS Cohort Study (MACS), "the test showed that estimated costs per year to treat a patient with antiretroviral drugs remained constant, but life expectancy increased," according to Glaxo researcher Sissi Pham and colleagues.
Pham et al. presented the model in a poster session at the American Society for Microbiology's 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), held September 28 to October 1, 1997, in Toronto, Ontario, Canada.
The model used prognostic data generated by University of Pittsburgh researcher and study co-author John Mellors. It assumed that a person with progressive HIV disease passes through five viral-load strata with corresponding CD4 counts: <500 copies/(micro)L and CD4 >500 cells/(micro)L; 501-3000 and CD4 350-500; 3001-10,000 and CD4 200-349; 10,001-30,000 and CD4 100-199; and >30,000 and CD4 <100.
The model also incorporated data from clinical trials on the ability of highly active antiretroviral therapy (HAART) to alter the natural progression of HIV disease.
The test of the model compared three scenarios: no effective antiretroviral therapy, one year of effective antiretroviral therapy, and two years of effective antiretroviral therapy.
The results:
* With no treatment, life expectancy was projected at 11.87 years after HIV infection at a cost of $8,083 per year.
* With a single year of effective treatment, life expectancy was projected at 12.77 years after HIV infection at an additional cost of $8,017 per year.
* With two years of effective treatment, life expectancy was projected at 13.66 years after HIV infection at an additional annual cost similar to that for a single year of treatment: $7,969 per year.
"The projected cost of treatment per year remained essentially the same, but patient life expectancy increased," the researchers concluded. "Therefore, the longer a patient can experience antiretroviral treatment efficacy, i.e., reductions in viral load and increases in CD4 cells, the more likely it is for that patient to have an increased life expectancy."
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