The effect of prophylaxis on pediatric HIV costs

Leslie S. Wilson*, Lori Hensic, Carly J. Paoli, Rituparna Basu, Maria Christenson, Judith T. Moskowitz, Diane Wara

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

The objective of this study was to determine and compare the cost to treat HIV(+) and HIV() pediatric patients both before and after HIV prophylaxis became the standard of care. Retrospective chart review of a pediatric HIV/AIDS specialty clinic's medical charts was conducted for clinical and healthcare utilization data on 125 children diagnosed from 1986 to 2007. Mean HIV-related costs were compared using bootstrapped t-tests for children born in the pre-prophylaxis (1979-1993) and prophylaxis eras (1994-2007). Patients were also stratified into two categories based on death during the follow-up period. Lastly, national cost-savings were estimated using mean costs, national number of at-risk births, and national perinatal HIV transmission rates in each era. For HIV(+) children, mean annual per patient treatment cost was 15,067 (95% CI: 10,169-19,965) in the pre-prophylaxis era (n = 40) and 14,959 (95% CI: 9140-20,779) in the prophylaxis era (n = 14); difference not statistically significant (p > 0.05). For HIV() children, mean annual per patient treatment cost was 204 (95% CI: 219-627) for the pre-prophylaxis era (n = 2) and 427 (95% CI: 277-579) for the prophylaxis era (n = 69); difference statistically significant (p < 0.05). A projected cost-savings of 16-23 million annually in the USA was observed due to the adoption of prophylaxis treatment guidelines in pediatric HIV care. The prophylaxis era of pediatric HIV treatment has been successful in decreasing perinatal HIV transmission and mortality, as reflected by clinical trials and national cost-savings data, and emphasizes the value of the rapid adoption of evidence-based practice guidelines.

Original languageEnglish (US)
Pages (from-to)108-118
Number of pages11
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2012

Keywords

  • AIDS
  • HIV
  • cost
  • cost-savings
  • pediatric
  • prophylaxis

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

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