Journal of medical economics · 2026
Incidence of comorbidities, healthcare resource utilization and costs among people with HIV.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Cohen Joshua P, Christoph Mary J, Anupindi Vamshi Ruthwik, Shaikh Nazneen Fatima, Coaquira JeanPierre, Mordi Uche, Haloski Kristen, Hsiao Alice, Near Aimee M
Аннотация
BACKGROUND: This study aimed to describe healthcare resource utilization (HCRU) and costs for people with HIV (PWH) during the year prior to and up to 5 years following HIV diagnosis.
METHODS: A retrospective observational cohort study was conducted using the IQVIA PharMetrics Plus administrative claims database. Adults aged ≥ 18 years with an initial HIV diagnosis between 1 January 2014 and 30 September 2023 and continuous medical and pharmacy benefit insurance coverage for ≥ 12 months prior to and 3 years after index date were identified. All‑cause HCRU, annual costs, and incidence of comorbidities were evaluated during the baseline year and annually up to 5 years post-diagnosis. Outcomes were assessed overall and stratified by age, timing of antiretroviral therapy (ART) initiation, and timing of HIV diagnosis.
RESULTS: The cohort included 2,370 PWH (mean age 45.6 years; 26.3% female). PWH with ≥ 1 inpatient admission increased from 13.4% at baseline to 27.0% in year 1 before leveling off at baseline levels thereafter. Mean total healthcare costs increased from $12,095 during baseline to $40,937 in year 1 and remained elevated through year 5 ($34,550). In year 1, medical costs ($20,986), driven by inpatient care, and pharmacy costs ($19,951) contributed roughly equally to total costs. Higher costs were observed among older adults, PWH initiating ART 8-75 days post-diagnosis compared to starting within 7 days, and those with late HIV diagnosis. Comorbidity rates were highest in year 1, particularly mental health conditions, AIDS‑defining conditions, and substance use disorders.
LIMITATIONS: Reliance on claims data precluded laboratory confirmation of late diagnosis.
CONCLUSIONS: HCRU and costs peaked during the first year following HIV diagnosis and remained elevated thereafter. Higher costs were observed among older adults, late diagnosis, and those who had delays initiating ART.
METHODS: A retrospective observational cohort study was conducted using the IQVIA PharMetrics Plus administrative claims database. Adults aged ≥ 18 years with an initial HIV diagnosis between 1 January 2014 and 30 September 2023 and continuous medical and pharmacy benefit insurance coverage for ≥ 12 months prior to and 3 years after index date were identified. All‑cause HCRU, annual costs, and incidence of comorbidities were evaluated during the baseline year and annually up to 5 years post-diagnosis. Outcomes were assessed overall and stratified by age, timing of antiretroviral therapy (ART) initiation, and timing of HIV diagnosis.
RESULTS: The cohort included 2,370 PWH (mean age 45.6 years; 26.3% female). PWH with ≥ 1 inpatient admission increased from 13.4% at baseline to 27.0% in year 1 before leveling off at baseline levels thereafter. Mean total healthcare costs increased from $12,095 during baseline to $40,937 in year 1 and remained elevated through year 5 ($34,550). In year 1, medical costs ($20,986), driven by inpatient care, and pharmacy costs ($19,951) contributed roughly equally to total costs. Higher costs were observed among older adults, PWH initiating ART 8-75 days post-diagnosis compared to starting within 7 days, and those with late HIV diagnosis. Comorbidity rates were highest in year 1, particularly mental health conditions, AIDS‑defining conditions, and substance use disorders.
LIMITATIONS: Reliance on claims data precluded laboratory confirmation of late diagnosis.
CONCLUSIONS: HCRU and costs peaked during the first year following HIV diagnosis and remained elevated thereafter. Higher costs were observed among older adults, late diagnosis, and those who had delays initiating ART.