AEGiS-13IAC: The costs and benefits of employer-sponsored anti-retroviral drug provision.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

The costs and benefits of employer-sponsored anti-retroviral drug provision.

Int Conf AIDS 2000 Jul 9-14; 13:22 (abstract no.. LbOr22)

Marseille E, Kahn JG, Saba J
Health Strategies International, Orinda, CA. Fax: 800-683-3442, E-mail: emarseille@home.com.

BACKGROUND: HIV/AIDS places a large cost burden on African business, including lost productivity, death payments, and new worker training. To reduce these costs, companies may be willing to increase payments for HIV therapy: prophylaxis and treatment of OIs and, especially with recent 85% price reductions, anti-retrovirals. This study estimates the economic costs and benefits to a Ugandan company of worker therapy with highly active anti-retroviral therapy (HAART) and prophylactic cotrimoxazole (PCTMX).

METHODS: We developed a computer-based economic model that accounts for HIV-related medical, productivity, and other costs, and projects savings from a program of HAART plus PCTMX provision in a company that currently funds limited treatment of OIs. We conducted a comparison analysis for PCTMX only. Employer HIV policies and HIV-related costs are generic, derived from published studies; these will be updated from a current case study of a major Ugandan corporation. Clinical effects of therapy are derived from the scientific literature. Results are subjected to sensitivity analysis.

RESULTS: We found, using generic estimates of HIV policies and costs, that with OI treatment only the company incurs annual costs of $327 per skilled and $185 per unskilled employee for HIV care, lost productivity, and other costs. Preliminary findings suggest that funding PCTMX generates annual savings of $74 per skilled and $42 per unskilled worker; HAART at new pricing plus PCTMX saves $86 per skilled worker per year and costs $24 per quality adjusted life-year gained for unskilled workers.

CONCLUSIONS: Funding PCTMX alone or HAART with PCTMX for skilled employees can save costs while improving health. Among unskilled workers, PCTMX is cost-saving and HAART plus PCTMX approaches break-even. These preliminary results will be recalculated with estimates derived from the case study. This model can be adapted to other payer perspectives, such as the public sector.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, HIV Infections, Acquired Immunodeficiency Syndrome, Retroviridae, Health Care Costs, Cost-Benefit Analysis, Cost of Illness, HIV-1, Quality-Adjusted Life Years, Efficiency, economics, AIDS
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