Bautista-Arredondo Sergio, Dmytraczenko Tania, Kombe Gilbert, Bertozzi Stefano M
Health Economics Division, National Institute of Public Health, Cuernavaca, Mexico.
Salud Publica Mex. 2008;50 Suppl 4:S437-44. doi: 10.1590/s0036-36342008001000004.
To determine the net effect of introducing highly active antiretroviral treatment (HAART) in Mexico on total annual per-patient costs for HIV/AIDS care, taking into account potential savings from treatment of opportunistic infections and hospitalizations.
A multi-center, retrospective patient chart review and collection of unit cost data were performed to describe the utilization of services and estimate costs of care for 1003 adult HIV+ patients in the public sector.
HAART is not cost-saving and the average annual cost per patient increases after initiation of HAART due to antiretrovirals, accounting for 90% of total costs. Hospitalizations do decrease post-HAART, but not enough to offset the increased cost.
Scaling up access to HAART is feasible in middle income settings. Since antiretrovirals are so costly, optimizing efficiency in procurement and prescribing is paramount. The observed adherence was low, suggesting that a proportion of these high drug costs translated into limited health benefits.
考虑到机会性感染治疗和住院治疗可能节省的费用，确定在墨西哥引入高效抗逆转录病毒治疗（HAART）对每位患者每年艾滋病护理总费用的净影响。
进行了一项多中心回顾性患者病历审查并收集单位成本数据，以描述服务利用情况并估算公共部门1003名成年HIV阳性患者的护理费用。
HAART并不能节省成本，开始HAART治疗后每位患者的平均年度费用因抗逆转录病毒药物而增加，占总成本的90%。HAART治疗后住院次数确实减少，但不足以抵消增加的成本。
在中等收入环境中扩大HAART的可及性是可行的。由于抗逆转录病毒药物成本高昂，优化采购和处方效率至关重要。观察到的依从性较低，表明这些高昂的药物成本中有一部分转化为有限的健康效益。
