[The campaign against AIDS and the costs incurred by various forms of management]

It is not easy to identify these costs. One must start by setting out the data of the whole health system, either in hospitals or privately. Furthermore, the statistical disposition is purely administrative, not epidemiological. No budget has been set aside for pathology. However, the total health costs involved are estimated at 2.2 billion francs for 1990. A 27% increase of costs brings the total to 2.7 billion in 1991. This figure represents 1.2% of the overall sum allocated to French hospitals. Local medical care by physicians in town will include expenses of 200 MF in 1991, or 7% of the total sanitary budget. The bulk of these expenses go to hospital care for chronic cases, also strategically important are the outpatients, whose costs accounts for only 15-20% of the total. Various medical expenses form an impressionable part of these costs. At the heart of these expenses is the cost related to the use of antivirals. The bill for 1990 was particularly high: 190 millions of francs. These expenses equal to those incurred by local medical care. Numerous productive steps have been taken by French hospitals in the last 3 years, enabling significant cost control, particularly in operational management. Today they are more selective, less expensive and less frequent. Due to a broadening number of charges to be paid in advance, the continuing increase of expenses remains a worry, as for the availability and costs of putting new molecules on the market. Without a strong liaison between doctors and managers, there can be no compromise in the improvement of medical care and the research for financial stability.