Analysis of the treatment cost of HIV/AIDS in Turkey
DOI:
https://doi.org/10.7175/fe.v17i1.1219Keywords:
HIV/AIDS, Cost of treatment, TurkeyAbstract
OBJECTIVE: Infection with the human immunodeficiency virus (HIV), the causative agent of acquired immune deficiency syndrome (AIDS), is a major global health problem. Patients with HIV can live normal lives with today’s new treatment options. As the treatment is generally successful, the life expectancy of patients infected with HIV is rising. As a result, the economic burden of HIV treatment on health systems is set to increase. According to the Ministry of Health, there were more than 6000 HIV-positive patients in Turkey in 2013. The aim of this study was to determine the direct costs of HIV treatment in Turkey.METHOD: A retrospective data analysis was performed from the reimbursement agency perspective. Data for 252 patients at a university hospital in Ankara from 2001 to 2012 were used for the analysis. The average costs of treatment per HIV patient and the average costs per HIV patient, depending on the state of the patient’s health, were calculated. The latter was determined according to the number of CD4 cells/ml, as defined by the CDC’s classification system for HIV infection. The cost of treatment was calculated based on published reimbursement prices in 2013, per patient per year.
RESULTS: The CD4 values of 25.3%, 29%, and 45.7% of the 252 patients were <100 cells/mm3, 100–300 cells/mm3, and >300 cells/mm3, respectively. The treatment costs per patient per year for 2013 for those with CD4 values of <100 cells/ mm3, 100–300 cells/mm3, and >300+ cells/mm3 were $ 5,637.04, $ 2,211.54, and $ 2,182.35, respectively. The weighted average of the treatment cost per patient was $ 3,344.64 for 2013.
CONCLUSION: This analysis is unique to Turkey and calculates the cost only of HIV treatment in Turkey. Lower CD4 values are associated with higher treatment costs. Appropriate HIV treatment is crucial for controlling CD4 values and lowering the treatment costs of HIV patients. These findings need to be considered by policy makers who may need to focus on HIV.
References
World Health Organization. Fast Track Ending The AIDS Epidemic by 2030. Available at: http://www.unaids.org/sites/default/files/media_asset/JC2686_WAD2014report_en.pdf (last accessed January 2015)
AIDS Cases and its Carriers in Turkey Distribution by years. Available at http://www.hatam.hacettepe.edu.tr/veriler_Haziran_2013.pdf (last accessed January 2015)
Montaner JS, Lima VD, Harrigan PR, et al. Expansion of HAART Coverage Is Associated with Sustained Decreases in HIV/AIDS Morbidity, Mortality and HIV Transmission: The “HIV Treatment as Prevention” Experience in a Canadian Setting. PLoS ONE 2014; 9: e87872; http://dx.doi.org/10.1371/journal.pone.0087872
Edward J, Millsa EJ, Bakandab C, et al. Mortality by baseline CD4 cell count among HIV patients initiating antiretroviral therapy: evidence from a large cohort in Uganda. AIDS 2011; 25: 851-5; http://dx.doi.org/10.1097/QAD.0b013e32834564e9
World Health Organization. Towards Universal Access Scaling up priority HIV/AIDS interventions in the health sector Progress Report, 2010. Available at: https://vpn.ku.edu.tr/iris/bitstream/10665/44443/1/,DanaInfo=apps.who.int+9789241500395_eng.pdf (last accessed January 2015)
British HIV Association. British HIV Association guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2012. HIV Medicine 2014; 15 (Suppl. 1): 1-85
Marseille E, Hofmann PB, Kahn JG. HIV prevention before HAART in sub-Saharan Africa. Lancet 2002; 359: 1851-56; http://dx.doi.org/10.1016/S0140-6736(02)08705-6
Creese A, Floyd K, Alban A, et al. Cost-effectiveness of HIV/AIDS interventions in Africa: a systematic review of the evidence. Lancet 2002; 359: 1635-42; http://dx.doi.org/10.1016/S0140-6736(02)08595-1
Erdem H ve Akova M. Leading infectious diseases problems in Turkey. Clin Microbiol Infect 2012; 18: 1056-67; http://dx.doi.org/10.1111/1469-0691.12000
Hutchinson AB, Farnham PG, Dean HD, et al. The Economic Burden of HIV in the United States in the Era of Highly Active Antiretroviral Therapy Evidence of Continuing Racial and Ethnic Differences. J Acquir Immune Defic Syndr 2006; 43: 451-7
Kockaya G, Wertheimer A. What are the top most costly diseases for USA? The alignment of burden of illness with prevention and screening expenditures. Journal of Health 2010; 2: 1174-8; http://dx.doi.org/10.4236/health.2010.210172
Leibowitz AA, Desmond K. Identifying a Sample of HIV-Positive Beneficiaries From Medicaid Claims Data and Estimating Their Treatment Costs. Am J Public Health 2015; 105: 567-74; http://dx.doi.org/10.2105/AJPH.2014.302263
Trapero-Bertran M, Oliva-Moreno J. Economic impact of HIV/AIDS: a systematic review in five European countries. Health Economics Review 2014; 4: 15; http://dx.doi.org/10.1186/s13561-014-0015-5
Schackman BR, Gebo KA, Walensky, RP, et al. The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States. Med Care 2006; 44: 990-7; http://dx.doi.org/10.1097/01.mlr.0000228021.89490.2a
Edward J, Millsa EJ, Bakandab C, et al. Mortality by baseline CD4 cell count among HIV patients initiating antiretroviral therapy: evidence from a large cohort in Uganda. AIDS 2011; 25: 851-5; http://dx.doi.org/10.1097/QAD.0b013e32834564e9
Fleishman JA, Yehia BR, Moore RD, et al.; HIV Research Network. The Economic Burden of Late Entry Into Medical Care for Patients With HIV Infection. Med Care 2010; 48): 1071-9; http://dx.doi.org/10.1097/MLR.0b013e3181f81c4a
Lima VD, Johnston K, Hogg RS, et al. Expanded access to highly active antiretroviral therapy: a potentially powerful strategy to curb the growth of the HIV epidemic. J Infect Dis 2008; 198: 59-67; http://dx.doi.org/10.1086/588673
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. The Publication Agreement can be downloaded here, and should be signed by the Authors and sent to the Publisher when the article has been accepted for publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (see The Effect of Open Access).
- Authors are permitted to post their work online after publication (the article must link to publisher version, in html format)