[Economic aspects of ambulatory and inpatient treatment of HIV positive patients].

Highly active antiretroviral therapy (HAART) was introduced in the midst of the 1990s. The sustained declin of morbidity and mortality by HAART has been proven to be cost effective despite high expenditures for regular administration of cost intensive antiretroviral drugs. Yearly direct treatment costs are estimated as high as [symbol: see text] 20,000 to [symbol: see text] 30,000 per case in Germany. Approximately two third of all direct costs are caused by the use of antiretrovirals. Despite rising use of HAART and increasing drug prices, general costs for treatment decreased in the last years. This is explained by declining costs for hospitalisation and by increasing use of less expensive drug combinations. In addition deferment of initiation of HAART to slightly more advanced stages of immunodeficiency is recommended in recent treatment guidelines and leads to further reduction of direct costs. Modified treatment concepts with presumed cost saving effects, like periods of antiretroviral treatment interruption, are currently under investigation.