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Neuropsychiatric Disorders Boost Cost of HIV Therapy

Managing cognitive, mental illness adds to costs both before and after diagnosis

TUESDAY, Oct. 31 (HealthDay News) -- The association between highly active antiretroviral therapy and HIV-associated neuropsychiatric disorders increases the cost of managing HIV patients both before and after treatment for mental illness, according to study findings published in the Oct. 24 issue of AIDS.

Christopher Power, M.D., of the University of Alberta in Edmonton, Canada, and colleagues calculated the costs per patient per month for 188 HIV-1 seropositive patients with neuropsychiatric disorders and 153 patients without neuropsychiatric disorders. Those with neuropsychiatric disorders were stratified into subgroups of cognitive impairment, peripheral neuropathies or other neuropsychiatric disorders.

The cost-per-month for patients without neuropsychiatric disorders was $916, compared with a mean of $1,371 for the 12 months prior to neuropsychiatric disorder diagnosis and $1,463 for the 12 months after diagnosis. The mean cost-per-month increased by 67 percent when the intragroup 12-month post-diagnosis and 18-month pre-diagnosis were compared. The increased costs were accounted for by increased clinic and physician visits, non-antiretroviral drugs and homecare.

"Our findings are particularly relevant in the context of extended survival of patients in the highly active antiretroviral therapy-era, as neuropsychiatric disorder is one of the major sources of morbidity and mortality in patients with HIV/AIDS," the authors write. "Cost analyses offer useful measures of evolving patient needs and provide a basis for allocation of health care resources," they conclude.

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