TY - JOUR
T1 - The effect of prophylaxis on pediatric HIV costs
AU - Wilson, Leslie S.
AU - Hensic, Lori
AU - Paoli, Carly J.
AU - Basu, Rituparna
AU - Christenson, Maria
AU - Moskowitz, Judith T.
AU - Wara, Diane
N1 - Funding Information:
The authors would like to acknowledge all our volunteers who reviewed charts to collect the utilization data: Jake Beverage, Lauren Louie, Sohail Manesh, Olga Mostovesky, Jessica Ng, Laura Ng, Sheila Nguyen, Mark Pregenzer, and Jeffery Proctor. This publication was supported by NIH/ NCRR UCSF-CTSI Grant Number UL1 RR024131. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
PY - 2012/1/1
Y1 - 2012/1/1
N2 - 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.
AB - 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.
KW - AIDS
KW - HIV
KW - cost
KW - cost-savings
KW - pediatric
KW - prophylaxis
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U2 - 10.1080/09540121.2011.592818
DO - 10.1080/09540121.2011.592818
M3 - Review article
C2 - 21780991
AN - SCOPUS:84856849905
SN - 0954-0121
VL - 24
SP - 108
EP - 118
JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
IS - 1
ER -