15th International AIDS Conference Bangkok, Thailand — July 11-July 16, 2004

Int Conf AIDS. 2004 Jul 11-16;15:Abstract No. LbOrE39

N Adomakoh¹, T Roach¹, A Abayomi², H Fraser², S Adomakoh^3
1Ministry of Health, Bridgetown, Barbados; ²University of the West Indies, School of Clinical Medicine & Research, Bridgetown, Barbados; ³University of the West Indies, School of Clinical Medicine, Bridgetown, Barbados

OBJECTIVES: To estimate and compare cost aspects and cost-effectiveness of providing (HAART) in the middle income microstate of Barbados.

METHODS: Data were collected pre and post- HAART (n=303, n=383 respectively). Costs were for personnel, drug, supplies, overheads, laboratory and other diagnostic services and were classified by disease stage. Main outcome measures were Annual cost of medical care of an HIV vs. AIDS infected adults, cost per death averted and cost per disability adjusted life year (DALY) gained. All costs are quoted in US Dollars.

RESULTS: A 40.8% reduction in inpatient costs; 56% reduction in deaths; 59.4% reduction in total annual hospital days; 42% reduction in admissions; and 29.9% reduction in average length of stay reduced by 29.9%. Outpatient visits rose by 128%. Net cost in the first year of the programme was $22 per patient month. When modeled under treatment using generic drugs, net cost fell dramatically to below the cost of treatment of HIV/AIDS patients before the introduction of the care and treatment programme, to minus $64 per patient per month. The corresponding cost-effectiveness ratios are $1085 per death averted or $24 per DALY with non generic drug; and treatment is highly cost-saving under the generic drug model.

CONCLUSION: Cost shift from inpatient to outpatient care is observed in the first year of HAART. Treatment is highly cost effective in Barbados setting.

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LbOrE39

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