Jang Yoonyoung, Kim Taehwa, Kim Brian H S, Kim Jung Ho, Seong Hye, Kim Youn Jeong, Park Boyoung
Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
Program in Regional Information, Department of Agricultural Economics and Rural Development, Seoul National University, Seoul, Korea.
J Cancer Prev. 2023 Jun 30;28(2):53-63. doi: 10.15430/JCP.2023.28.2.53.
This study aimed to estimate the medical cost of cancer in the first five years of diagnosis and in the final six months before death in people who developed cancer after human immunodeficiency virus (HIV) infection in Korea. The study utilized the Korea National Health Insurance Service-National Health Information Database (NHIS-NHID). Among 16,671 patients diagnosed with HIV infection from 2004 to 2020 in Korea, we identified 757 patients newly diagnosed with cancer after HIV diagnosis. The medical costs for 60 months after diagnosis and the last six months before death were calculated from 2006 to 2020. The mean annual medical cost due to cancer in HIV-infected people with cancer was higher for acquired immunodeficiency syndrome (AIDS)-defining cancers (48,242 USD) than for non-AIDS-defining cancers (24,338 USD), particularly non-Hodgkin's lymphoma (53,007 USD), for the first year of cancer diagnosis. Approximately 25% of the cost for the first year was disbursed during the first month of cancer diagnosis. From the second year, the mean annual medical cost due to cancer was significantly reduced. The total medical cost was higher for non-AIDS-defining cancers, reflecting their higher incidence rates despite lower mean medical costs. The mean monthly total medical cost per HIV-infected person who died after cancer diagnosis increased closer to the time of death. The estimated burden of medical costs in patients with HIV in the present study may be an important index for defining healthcare policies in HIV patients in whom the cancer-related burden is expected to increase.
本研究旨在估算韩国人类免疫缺陷病毒（HIV）感染后罹患癌症患者在诊断后的头五年以及死亡前最后六个月的癌症医疗费用。该研究利用了韩国国民健康保险服务-国民健康信息数据库（NHIS-NHID）。在2004年至2020年期间韩国诊断出的16,671例HIV感染患者中，我们确定了757例在HIV诊断后新诊断出癌症的患者。计算了2006年至2020年诊断后60个月以及死亡前最后六个月的医疗费用。在癌症诊断的第一年，患有癌症的HIV感染者中，因获得性免疫缺陷综合征（AIDS）定义的癌症导致的年均医疗费用（48,242美元）高于非AIDS定义的癌症（24,338美元），特别是非霍奇金淋巴瘤（53,007美元）。癌症诊断第一年费用的约25%在诊断后的第一个月支出。从第二年起，因癌症导致的年均医疗费用显著降低。非AIDS定义的癌症总医疗费用更高，这反映出尽管其平均医疗费用较低但其发病率较高。癌症诊断后死亡的HIV感染者的月均总医疗费用在接近死亡时增加。本研究中估计的HIV患者医疗费用负担可能是制定预计癌症相关负担会增加的HIV患者医疗政策的重要指标。
