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The effect of prophylaxis on pediatric HIV costs

Leslie S Wilson1, Lori Hensic, Carly J Paoli

  • 1Department of Clinical Pharmacy, University of California, San Francisco, USA. wilsonl@pharmacy.ucsf.edu

AIDS Care
|July 26, 2011
PubMed

Insights

HIV prophylaxis significantly reduced treatment costs for HIV-negative children and led to substantial national cost savings, demonstrating the value of evidence-based guidelines in pediatric HIV care.

Area of Science:

  • Public Health
  • Pediatric Infectious Diseases
  • Health Economics

Background:

  • Human Immunodeficiency Virus (HIV) infection in children poses significant healthcare challenges.
  • The adoption of prophylaxis treatment guidelines aimed to reduce perinatal HIV transmission and associated costs.
  • Understanding the economic impact of these guidelines is crucial for resource allocation and public health policy.

Purpose of the Study:

  • To compare the treatment costs for pediatric patients with and without HIV before and after the implementation of HIV prophylaxis.
  • To estimate the national cost-savings resulting from the adoption of prophylaxis in pediatric HIV care.
  • To evaluate the effectiveness of evidence-based practice guidelines in pediatric HIV management.

Main Methods:

  • Retrospective review of medical charts from a pediatric HIV/AIDS specialty clinic (1986-2007).
  • Analysis of clinical and healthcare utilization data for 125 children.
  • Comparison of mean annual per-patient treatment costs between pre-prophylaxis (1979-1993) and prophylaxis (1994-2007) eras using bootstrapped t-tests.
  • Estimation of national cost-savings based on mean costs, at-risk births, and perinatal HIV transmission rates.

Main Results:

  • Mean annual treatment costs for HIV-positive children showed no statistically significant difference between the pre-prophylaxis ($15,067) and prophylaxis ($14,959) eras.
  • Mean annual treatment costs for HIV-negative children significantly increased from $204 (pre-prophylaxis) to $427 (prophylaxis era) (p < 0.05).
  • Projected national cost-savings of $16-23 million annually in the USA were observed due to the adoption of prophylaxis guidelines.

Conclusions:

  • The prophylaxis era has been successful in decreasing perinatal HIV transmission and mortality in pediatric patients.
  • The adoption of evidence-based practice guidelines for pediatric HIV treatment demonstrates significant value and cost-effectiveness.
  • While costs for HIV-negative children increased, the overall reduction in HIV transmission and associated long-term costs resulted in substantial national savings.

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