The effect of prophylaxis on pediatric HIV costs

Bibliographic Data

ID19444333
AuthorsLeslie Wilson (0000-0002-3305-8730, University of California, San Francisco, corresponding author), Leslie S Wilson (a Department of Clinical Pharmacy , University of California , San Francisco , USA), Lori Hensic (b Department of Pharmacy Practice , Touro University , Vallejo , USA), Carly J Paoli (0000-0002-1331-9462, a Department of Clinical Pharmacy , University of California , San Francisco , USA), Rituparna Basu (0000-0001-9954-4216, a Department of Clinical Pharmacy , University of California , San Francisco , USA), Maria Christenson (a Department of Clinical Pharmacy , University of California , San Francisco , USA), Judith T Moskowitz (0000-0002-1399-3318, d OSHER Center for Integrative Medicine , University of California , San Francisco , USA), Diane Wara (e Department of Pediatric Immunology , University of California , San Francisco , USA), Diane W Wara (University of California, San Francisco)
Year2012
Volume24
Issue1
Pages108-118
Publication date2012-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2011.592818
PMID21780991
PMCIDPMC4201115
OpenAlexW1964304747
LanguageEN
References cited16

The objective of this study was to determine and compare the cost to treat HIV(+) and HIV(-) pediatric patients both before and after HIV prophylaxis became the standard of care. Retrospective chart review of a pediatric HIV/AIDS specialty clinic's medical charts was conducted for clinical and healthcare utilization data on 125 children diagnosed from 1986 to 2007. Mean HIV-related costs were compared using bootstrapped t-tests for children born in the pre-prophylaxis (1979-1993) and prophylaxis eras (1994-2007). Patients were also stratified into two categories based on death during the follow-up period. Lastly, national cost-savings were estimated using mean costs, national number of at-risk births, and national perinatal HIV transmission rates in each era. For HIV(+) children, mean annual per patient treatment cost was $15,067 (95% CI: $10,169-$19,965) in the pre-prophylaxis era (n = 40) and $14,959 (95% CI: $9140-$20,779) in the prophylaxis era (n = 14); difference not statistically significant (p > 0.05). For HIV(-) children, mean annual per patient treatment cost was $204 (95% CI: $219-$627) for the pre-prophylaxis era (n = 2) and $427 (95% CI: $277-$579) for the prophylaxis era (n = 69); difference statistically significant (p < 0.05). A projected cost-savings of $16-23 million annually in the USA was observed due to the adoption of prophylaxis treatment guidelines in pediatric HIV care. The prophylaxis era of pediatric HIV treatment has been successful in decreasing perinatal HIV transmission and mortality, as reflected by clinical trials and national cost-savings data, and emphasizes the value of the rapid adoption of evidence-based practice guidelines

Intensive care medicine · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Pneumocystis jirovecii pneumonia detection and treatment · Pediatrics · Virology

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