Adherence to HIV Drugs May Reduce Overall Medical Costs

In resource-limited settings, sticking to medications likely to reduce risk of hospitalization

TUESDAY, Jan. 5 (HealthDay News) -- In resource-poor settings, high adherence to antiretroviral therapy is associated with reduced overall direct health care costs, especially those associated with hospitalization, according to a study in the Jan. 5 issue of the Annals of Internal Medicine.

Jean B. Nachega, M.D., of the Harvard School of Public Health in Boston, and colleagues conducted a study of 6,833 HIV-positive adults in South Africa who started antiretroviral therapy through a private-sector program. Pharmacy claims were used to measure drug regimen adherence.

The researchers averaged out the monthly direct health care costs between August 2000 and April 2006, and found that the total mean monthly cost was $370, including $32 for the antiretroviral drugs, $151 for hospitalizations and $76 for consultations. For those in the lowest quartile for adherence to antiretroviral medication, hospitalization costs accounted for 51 percent of total costs, compared to 29 percent for those in the highest quartile for adherence, the data revealed.

"If antiretroviral therapy costs continue to decrease, then the relative contribution of antiretroviral therapy costs to total costs will also decrease, which will lead to further program cost savings for patients with higher adherence," the authors write. "Future research should prospectively investigate the long-term effect of antiretroviral therapy adherence on costs and patient outcomes, as well as the cost-effectiveness of simple, valid, and reliable interventions to improve antiretroviral therapy adherence in private as well as public-sector programs."

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