8th Annual Conference Of The British HIV Association [BHIVA] 19 – 21 April 2002, University of York, York

[AUTHOR(S):] EJ Beck¹, A Miners¹, G Kinghorn², S Mandalia¹, D Parmar¹, M Youle¹, M Fisher², J Innes², MA Johnson², AL Pozniak², A Tang², IG Williams², BG Gazzard¹ for the NPMS-HHC Steering Group
¹ NPMS-HHC CAC, Chelsea & Westminster Hospital, ² NPMS-HHC sites

BHIVA Conf 2002 Apr 19-21;8:O3

AIM: To estimate population cost of HIV service provision in England for 1996–2004.

METHODS: Costs by Communicable Disease Surveillance Centre (CDSC) stage of HIV infection were estimated for the years 1996-1999. Multiplied by those using NHS services, direct population costs for different highly active antiretroviral therapy (HAART) regimens (PI, protease inhibitor; NRTI, nucleoside reverse transcriptase inhibitor; NNRTI, nonnucleoside reverse transcriptase inhibitor) were estimated. Patients using services in 2000-2004 were projected and the population cost estimated for these years (1999/2000 prices).

RESULTS: People using HIV services increased by 25% from 13,400 in 1996 to 17,981 in 1999: if all were treated with 2NRTIs+1NNRTI, direct population costs increased by 29% from £209 million (m) (£176m– £253m) to £266m (£226m–£321m). Indirect costs added £53m–£133m in 1999. From a public sector perspective, estimates ranged from 28% to 34% of direct costs, assuming a 100% loss in production; with 50% loss of production, estimates varied between 20% and 25%. From a societal perspective, estimates varied between 22% and 27%, assuming a 100% loss of production, and 13–16% of direct costs for 50% production loss. People projected to be using HIV services increased by 92% from 13,400 in 1996 to 25,667 in 2004; total costs estimates increased by 76% from £316m (£283m–£360m) in 1996 to £556m (£498m–£634m) in 2004 managed with 2NRTIs+1NNRTI. Regimens with 2NRTIs + 1PI or 2PIs provided higher population cost estimates.

CONCLUSIONS: Increased resources are required to maintain current standards of care. New configurations of HIV service delivery should be explored in conjunction with measures to reduce HIV transmission.

PRESENTING AUTHOR: EJ Beck

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