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[Direct pharmaceutical costs, diagnostic related groups and CD4 cell count in hospitalized HIV-infected patients]
J Serrais1, J Mallolas, J Ribas
1Servicio de Farmacia, Hospital Clínic i Provincial, Barcelona.
Insights
Direct pharmaceutical costs for HIV patients were high, driven by antibiotics and antivirals. Lower CD4 cell counts correlated with higher mean costs, indicating disease severity influences spending.
Area of Science:
- Pharmacoeconomics
- Infectious Diseases
- Immunology
Context:
- Human Immunodeficiency Virus (HIV) infection presents significant healthcare challenges.
- Pharmaceutical costs are a major component of managing HIV-infected patients.
- CD4 cell count is a key indicator of immune status in HIV patients.
Purpose:
- To estimate direct pharmaceutical costs in hospitalized HIV patients.
- To analyze the variability of these costs.
- To investigate the relationship between pharmaceutical costs and CD4 cell count.
Summary:
- A study of 877 HIV patients revealed that antibiotic and antiviral drugs constituted 72% of total pharmaceutical costs.
- High variability in costs was observed, particularly in specific diagnosis-related groups (GRD 489, 490).
- While no linear correlation existed, lower CD4 cell counts (<60 x 10^6/L) were associated with greater mean pharmaceutical expenditures, reflecting infection-related treatment needs.
Impact:
- Findings highlight the substantial economic burden of pharmaceutical treatments for HIV patients.
- Understanding cost drivers, like infection type indicated by CD4 count, can inform resource allocation and cost-management strategies.
- This research provides insights into the pharmacoeconomic impact of HIV disease progression and management.
Background:
To estimate the direct pharmaceutical costs of the HIV-infected patients admitted in the HCP, the variability and the relation between CD4 cell count.
Patients And Methods:
We collected for each patient admitted to Department of infectious Diseases between 1/1/93 to 12/12/94 the direct pharmaceutical cost for GRD and diagnosis discharge. Also we collected the lymphocyte CD4 cell count.
Results:
The number of patients observed was 877 and the total pharmaceutical cost was 65,756,751 pts., 24,900,827 pts. were spent in antibiotic drugs and 22,225,273 pts. in antiviral drugs (non anti-HIV included). 568 patient had CD4 cell count on admission. 75% of them had a CD4 cell count less than 50 x 10(4)/l. The variability of the pharmaceutical cost estimated in the GRD 489, 490 and diagnosis discharge was higher than 150%. There was not lineal correlation between the total costs and the CD4 cell count. The mean direct pharmaceutical costs in patients with CD4 cell count less than 60 x 10(6)/l was greater than in the others.
Conclusions:
Antibiotic and antiviral drugs accounted for the 72% of global pharmaceutical cost in HIV patients admitted. The variability observed in the GRD 489 and 490 was high. The direct pharmaceutical costs were conditioned by the lymphocyte CD4 cell count because this parameter determine the type of infections disease that these patients suffered.