Study Shows Significant Cost Savings in Preventing HIV Infection

Preventing HIV infection in one 35-year-old high-risk person saves $229,800 in medical costs over a lifetime, according to an AHRQ-funded study. Researchers, including AHRQ’s John A. Fleishman, Ph.D., estimated lifetime medical costs for people with and without HIV to determine the cost saved by preventing one HIV infection. The article and abstract “The Lifetime Medical Cost Savings from Preventing HIV in the United States,” appeared online February 24 in the journal Medical Care. Although people who acquire HIV infection can be successfully treated and continue to live a near-normal life, this study demonstrates the significant value of preventing HIV infection, from both cost and quality-of-life perspectives.

2015 Apr;53(4):293-301. doi: 10.1097/MLR.0000000000000308.

The Lifetime Medical Cost Savings From Preventing HIV in the United States.

Schackman BR1, Fleishman JA, Su AE, Berkowitz BK, Moore RD, Walensky RP, Becker JE, Voss C, Paltiel AD, Weinstein MC, Freedberg KA, Gebo KA, Losina E.

Author information

Abstract

OBJECTIVE:

Enhanced HIV prevention interventions, such as preexposure prophylaxis for high-risk individuals, require substantial investments. We sought to estimate the medical cost saved by averting 1 HIV infection in the United States.

METHODS:

We estimated lifetime medical costs in persons with and without HIV to determine the cost saved by preventing 1 HIV infection. We used a computer simulation model of HIV disease and treatment (CEPAC) to project CD4 cell count, antiretroviral treatment status, and mortality after HIV infection. Annual medical cost estimates for HIV-infected persons, adjusted for age, sex, race/ethnicity, and transmission risk group, were from the HIV Research Network (range, $1854-$4545/mo) and for HIV-uninfected persons were from the Medical Expenditure Panel Survey (range, $73-$628/mo). Results are reported as lifetime medical costs from the US health system perspective discounted at 3% (2012 USD).

RESULTS:

The estimated discounted lifetime cost for persons who become HIV infected at age 35 is $326,500 (60% for antiretroviral medications, 15% for other medications, 25% nondrug costs). For individuals who remain uninfected but at high risk for infection, the discounted lifetime cost estimate is $96,700. The medical cost saved by avoiding 1 HIV infection is $229,800. The cost saved would reach $338,400 if all HIV-infected individuals presented early and remained in care. Cost savings are higher taking into account secondary infections avoided and lower if HIV infections are temporarily delayed rather than permanently avoided.