Cost-effectiveness of highly active antiretroviral therapy for HIV infection in Taiwan
Journal
Journal of the Formosan Medical Association
Journal Volume
106
Journal Issue
8
Pages
631-640
Date Issued
2007
Author(s)
Abstract
Background/Purpose: Since the late 1980s, the Taiwanese government has provided all HIV-infected citizens with free access to antiretroviral therapy. Recently, there is controversy as to whether or not free access to expensive highly active antiretroviral therapy (HAART) should be continued for HIV-infected patients. This study aimed to evaluate the cost-effectiveness of HAART therapy. Methods: HAART-associated improvement in survival was obtained by analyzing the follow-up data of all HIV-positive patients identified during April 1984 to March 1997 (pre-HAART era) and May 1997 to April 2003 (HAART era) in Taiwan. Data on quality of life in HIV-positive patients was obtained from a cross-sectional survey of 224 patients using standard gamble method and World Health Organization Quality of Life-BREF instrument. Information regarding the cost of HAART was obtained from the National Health Insurance (NHI). Results: In 2000, the average annual NHI expenditure on HAART per HIV-positive patient receiving HAART was NT$210,018 (US$6177, at an exchange rate of 34.0 NT$/US$). In the AIDS group, the cost was NT$176,441 (US$5189) per life year gained and NT$241,700 (US$7109) per quality-adjusted life year gained. For non-AIDS patients, the corresponding costs were NT$226,156 (US$6652) and NT$332,582 (US$9782), respectively. These estimates have not yet included the additional cost savings from HAART-associated reduction in hospitalization and use of antimicrobial agents for opportunistic infections, and the additional life years gained from the reduction in HIV transmission under the universal availability of HAART. Conclusion: HAART for HIV infection is cost-effective, especially when the societal and epidemiologic factors are considered. We recommend that the policy of providing free HAART to all HIV-infected citizens be continued. ? 2007 Elsevier & Formosan Medical Association.
SDGs
Other Subjects
antiinfective agent; antiretrovirus agent; nucleoside analog; proteinase inhibitor; RNA directed DNA polymerase inhibitor; acquired immune deficiency syndrome; AIDS related complex; article; controlled study; cost control; cost effectiveness analysis; drug cost; follow up; highly active antiretroviral therapy; hospital cost; human; Human immunodeficiency virus; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; major clinical study; national health insurance; opportunistic infection; quality adjusted life year; quality of life; survival rate; Taiwan; virus transmission; world health organization
Publisher
Scientific Communications International Ltd
Type
journal article