Wilkinson Anna L, McMahon James, Cheah Yik-Siang, Bradshaw Catriona S, El-Hayek Carol, Stoové Mark
Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.
Alfred Health, Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Vic. 3053, Australia.
Sex Health. 2015 Mar;12(1):34-8. doi: 10.1071/SH14144.
Background An estimated 25700 people live with diagnosed HIV (PLWH) in Australia and ~1200 newly diagnosed cases were notified in 2012. New HIV prevention strategies focus on individual uptake of treatment; however, a potential barrier is the financial burden of antiretroviral treatment (ART). We describe HIV ART dispensed and the estimated associated costs for PLWH in Victoria.
A retrospective cross-sectional study of pharmacy data on ART dispensed between January 2012 and November 2013 from a hospital network, including Victoria's largest sexual health clinic was conducted. Estimated annual patient costs of ART were calculated by the number of items dispensed per year, concession status, dispensing site and applicable co-payment.
A total of 60225 dispensing records from 3903 individuals were included; this represented 83.8% of pharmaceutical benefits scheme-recorded ART dispensed in Victoria over this period. The estimated annual co-payment costs for patients without a concession card and who were collecting two medications was $433.20. One-fifth of patients (21.3%) collected four or more items, equating to an estimated annual cost of at least $866.40 without a concession card and $141.60 with a concession card. Of those dispensed four or more items, 40.4% were concession card holders.
There may be meaningful patient costs associated with accessing ART for some PLWH. New HIV treatment-based prevention strategies need to consider financial vulnerabilities and appropriately targeted initiatives to alleviate patient costs associated with ART, ensuring they do not act as a barrier to commencement of and adherence to HIV treatment.
背景 据估计，澳大利亚有25700人被诊断感染艾滋病毒（艾滋病毒感染者），2012年报告了约1200例新诊断病例。新的艾滋病毒预防策略侧重于个人接受治疗；然而，一个潜在障碍是抗逆转录病毒治疗（ART）的经济负担。我们描述了维多利亚州艾滋病毒感染者所配发的抗逆转录病毒治疗药物及其估计的相关费用。
对2012年1月至2013年11月期间来自一个医院网络（包括维多利亚州最大的性健康诊所）的抗逆转录病毒治疗药物药房数据进行回顾性横断面研究。抗逆转录病毒治疗的估计年度患者费用通过每年配发的药品数量、优惠状况、配药地点和适用的自付费用来计算。
共纳入了来自3903名个体的60225条配药记录；这占该时期维多利亚州药品福利计划记录的抗逆转录病毒治疗药物配发量的83.8%。没有优惠卡且领取两种药物的患者估计年度自付费用为433.20美元。五分之一的患者（21.3%）领取了四种或更多药品，这相当于没有优惠卡时估计年度费用至少为866.40美元，有优惠卡时为141.60美元。在领取四种或更多药品的患者中，40.4%是优惠卡持有者。
对于一些艾滋病毒感染者来说，获取抗逆转录病毒治疗可能会产生可观的患者费用。基于艾滋病毒治疗的新预防策略需要考虑经济脆弱性，并采取适当的针对性举措来减轻与抗逆转录病毒治疗相关的患者费用，确保这些费用不会成为开始和坚持艾滋病毒治疗的障碍。
