PharmacoEconomics

, Volume 19, Issue 1, pp 13–39

The Cost of HIV Treatment and Care

A Global Review
Review Article

Abstract

This review of published studies on the costs of HIV treatment and care describes some of the recent developments that have influenced these costs in industrialised and industrialising countries, especially within the context of changing drug treatments. Some of the different approaches to estimating the economic impact of HIV infection are briefly presented. The methods used to review the literature are described, particularly the criteria of a scoring system that was specifically developed to systematically screen some of the studies identified. The mean review score for studies dealing with direct hospital costs increased significantly (p = 0.003) over the 3 periods analysed (before 1987, 1987 to 1995, and 1996 and beyond), indicating that the overall ‘quality’ of studies increased over time.

All cost estimates, other than those from non-industrialised regions, were converted to 1996 US dollars using country-specific total health expenditure inflaters and country-specific Gross Domestic Product Purchasing Power Parity converters. A summary of hospital cost estimates over time and by region demonstrated that the costs of treating asymptomatic individuals and people with symptomatic non-AIDS increased over the period, but that the costs of treating individuals with AIDS appears to have stabilised since the late 1980s. As fewer studies could be identified on the costs of community and informal care, indirect productivity costs and population cost estimates, and costs of care for children with HIV infection, all of these studies were reviewed without the use of the scoring system.

Finally, the discussion explores the evidence on the global costs of HIV in non-industrialised economies and the affordability of HIV treatment and care. Some suggestions for the direction of future HIV costing studies are also presented. A need remains for good quality cost data. Adequate research effort should be directed to improving the scope and quality of information on costs of HIV service provision around the world.

References

  1. 1.
    Drummond MF, O’Brien B, Stoddart GL, et al. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press, 1997Google Scholar
  2. 2.
    Scitovsky AA. Studying the cost of HIV-related illnesses: reflections on the moving target. Milbank Q 1989; 67: 318–44PubMedCrossRefGoogle Scholar
  3. 3.
    Shapiro MF, Morton SC, McCaffrey DF, et al. Variations in the care of HIV-infected adults in the United States: results from the HIV cost and services utilization study. JAMA 1999; 281: 2305–15PubMedCrossRefGoogle Scholar
  4. 4.
    Centers for Disease Control. Pneumocystis pneumonia. MMWR Morb Mortal Wkly Rep 1981; 30: 250Google Scholar
  5. 5.
    Centers for Disease Control. Kaposi’s sarcoma. MMWR Morb Mortal Wkly Rep 1981; 30: 305–8Google Scholar
  6. 6.
    UNAIDS. AIDS epidemic update. Joint United Nations Programme on AIDS. Geneva: World Health Organization, 1999Google Scholar
  7. 7.
    Merson M. HIV infection: the global perspective. J Acquir Immune Defic Syndr 1991; 4: 305Google Scholar
  8. 8.
    Mann JM, Chin J. AIDS: a global perspective. N Engl J Med 1988; 319: 302–3PubMedCrossRefGoogle Scholar
  9. 9.
    Pepin J, Plummer FA, Brunham RC, et al. The interaction of HIV infection and other sexually transmitted diseases: an opportunity for intervention. AIDS 1989; 3: 3–9PubMedGoogle Scholar
  10. 10.
    Centers for Disease Control. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Morb Mortal Wkly Rep 1992; 41: 1–19Google Scholar
  11. 11.
    Ho DD, Neumann AU, Perelson AS, et al. Rapid turnover of plasma virions and CD4 lymphocytes on HIV-1 infection. Nature 1995; 373: 123–6PubMedCrossRefGoogle Scholar
  12. 12.
    Wei X, Ghosh SK, Taylor ME, et al. Viral dynamics in human immunodeficiency virus type 1 infection. Nature 1995; 373: 117–22PubMedCrossRefGoogle Scholar
  13. 13.
    Fischl MA, Richman DD, Grieco MH, et al. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. N Engl J Med 1987; 317: 185–91PubMedCrossRefGoogle Scholar
  14. 14.
    Hammer SM. Advances in antiretroviral therapy and viral load monitoring. AIDS 1996; 10 Suppl. 3: S1–11PubMedGoogle Scholar
  15. 15.
    Delta Co-ordinating Committee. Delta: a randomised double blind controlled trial comparing combinations of zidovudine plus didanosine or zalcitabine with zidovudine alone in HIV infected individuals. Lancet 1996; 348: 283–91CrossRefGoogle Scholar
  16. 16.
    Saravolatz LD, Winslow DL, Collins G, et al. Zidovudine alone or in combination with didanosine or zalcitabine in HIV-infected patients with the acquired immunodeficiency syndrome or fewer than 200 CD4 cells per cubic millimeter. Investigators for the Terry Beirn Community Programs for Clinical Research on AIDS. N Engl J Med 1996; 335: 1099–106PubMedCrossRefGoogle Scholar
  17. 17.
    Perelson AS, Essunger P, Cao Y, et al. Decay characteristics of HIV-1-infected compartments during combination therapy. Nature 1997; 387: 188–91PubMedCrossRefGoogle Scholar
  18. 18.
    Gazzard B, Moyle G. 1998 revision to the British HIV Association guidelines for antiretroviral treatment of HIV seropositive individuals. BHIVA Guidelines Writing Committee. Lancet 1998; 352: 314–6PubMedCrossRefGoogle Scholar
  19. 19.
    Beck EJ, Mandalia S, Parmer D, et al., NPMS Steering Group. Reduced HIV disease progression and mortality due to combination antiretroviral therapy in English NPMS-HHC clinics [poster TuPeC3331]. 13th International AIDS Conference; 2000 Jul 11; DurbanGoogle Scholar
  20. 20.
    Carpenter CC, Fischl MA, Hammer SM, et al. Antiretroviral therapy for HIV infection in 1997. Updated recommendations of the International AIDS Society — USA Panel. JAMA 1997; 277: 1962–9PubMedCrossRefGoogle Scholar
  21. 21.
    Carpenter CC, Fischl MA, Hammer SM, et al. Antiretroviral therapy for HIV infection in 1998: updated recommendations of the International AIDS Society — USA Panel. JAMA 1998; 280: 78–86PubMedCrossRefGoogle Scholar
  22. 22.
    Curtis H. Funding implications of combination therapies. J Comb Ther 1997; 2: 27–8Google Scholar
  23. 23.
    Bloom DE, River Path Association. Something to be done: treating HIV/AIDS. Science 2000; 288: 2171–3PubMedCrossRefGoogle Scholar
  24. 24.
    Finkler SA. The distinction between costs and charges. Ann Intern Med 1982; 96: 102–9PubMedGoogle Scholar
  25. 25.
    Beck EJ, Beecham J, Mandalia S, et al. What is the cost of getting the price wrong? J Public Health Med 1999; 21: 311–7PubMedCrossRefGoogle Scholar
  26. 26.
    Rees M. Report on the HIV/AIDS costing ‘revisit’. London: Department of Economics, University of Buckingham, 1995Google Scholar
  27. 27.
    Wright KG, Haycox A. Public sector costs of caring for mentally handicapped persons in a large hospital. Discussion paper no. 1. York: Centre for Health Economics, University of York, 1984Google Scholar
  28. 28.
    Tolley K, Gyldmark M. The treatment and care costs of people with HIV infection or AIDS: development of a standardised cost framework for Europe. Health Policy 1993; 24: 55–70PubMedCrossRefGoogle Scholar
  29. 29.
    Knapp M. Background theory. In: Netten A, Beecham J, editors. Costing community care: theory & practice. Aldershot: Ashgate Publishing Ltd, 1993Google Scholar
  30. 30.
    Knapp M, Beecham J, Renshaw J. The cost-effectiveness of psychiatric provision services. Personal Social Services Research Unit discussion paper 533/2. Kent: University of Kent, 1987Google Scholar
  31. 31.
    The World Bank. World Bank development report 1998/99: knowledge for development. New York (NY): Oxford University Press, 1999Google Scholar
  32. 32.
    Hiatt RA, Quesenberry CPJ, Selby JV, et al. The cost of acquired immunodeficiency syndrome in northern California. The experience of a large prepaid health plan. Arch Intern Med 1990; 150: 833–8PubMedCrossRefGoogle Scholar
  33. 33.
    Solomon DJ, Hogan AJ, Bouknight RR, et al. Analysis of Michigan Medicaid costs to treat HIV infection. Public Health Rep 1989; 104: 416–24PubMedGoogle Scholar
  34. 34.
    Andrews RM, Keyes MA, Fanning TR, et al. Lifetime medical service utilization and expenditures for AIDS in New York and California. J Acquirr Immune Defic Syndr 1991; 4: 1046–58Google Scholar
  35. 35.
    Moss NE, Kahn JG, Benjamin AE, et al. Medical care utilization and associated charges for patients with symptomatic HIV disease. AIDS Public Policy J 1991; 6: 125–9Google Scholar
  36. 36.
    Beck EJ, Kennelly J, McKevitt C, et al. Changing use of hospital services and costs at a London AIDS referral centre, 1983–1989. AIDS 1994; 8: 367–77PubMedCrossRefGoogle Scholar
  37. 37.
    Whyte BM, Evans DB, Schreurs EJ, et al. The costs of hospital-based medical care for patients with the acquired immunodeficiency syndrome. Med J Austr 1987; 147: 269–72Google Scholar
  38. 38.
    Scitovsky AA, Cline MW, Abrams DI. Effects of the use of AZT on the medical care costs of persons with AIDS in the first 12 months. J Acquir Immune Defic Syndr 1990; 3: 904–12PubMedGoogle Scholar
  39. 39.
    Seage III GR, Landers S, Lamb GA, et al. Effect of changing patterns of care and duration of survival on the cost of treating the acquired immunodeficiency syndrome (AIDS). Am J Public Health 1990; 80: 835–9PubMedCrossRefGoogle Scholar
  40. 40.
    Bennett CL, Cvitanic M, Pascal A. The costs of AIDS in Los Angeles. J Acquir Immune Defic Syndr 1991; 4: 197–203PubMedCrossRefGoogle Scholar
  41. 41.
    Andrulis DP, Weslowski VB, Hintz E, et al. Comparisons of hospital care for patients with AIDS and other HIV-related conditions. JAMA 1992; 267: 2482–6PubMedCrossRefGoogle Scholar
  42. 42.
    Bennett C, Pascal A, Cvitanic M, et al. Medical care costs of intravenous drug users with AIDS in Brooklyn. J Acquir Immune Defic Syndr 1992; 5: 1–6PubMedGoogle Scholar
  43. 43.
    Rietmeijer CA, Davidson AJ, Foster CT, et al. Cost of care for patients with human immunodeficiency virus infection. Patterns of utilization and charges in a public health care system. Arch Intern Med 1993; 153: 219–25PubMedCrossRefGoogle Scholar
  44. 44.
    Hellinger FJ, Fleishman JA, Hsia DC. AIDS treatment costs during the last months of life: evidence from the ACSUS. Health Serv Res 1994; 29: 569–81PubMedGoogle Scholar
  45. 45.
    Epstein AM, Seage G, Weissman JS, et al. Costs of medical care and out-of-pocket expenditures for persons with AIDS in the Boston Health Study. Inquiry 1995; 32: 211–21PubMedGoogle Scholar
  46. 46.
    Moore RD, Chaisson RE. Costs to Medicaid of advancing immunosuppression in an urban HIV-infected patient population in Maryland. J Acquir Immune Defic Syndr Hum Retrovirol 1997; 14: 223–31PubMedCrossRefGoogle Scholar
  47. 47.
    Perdue EB, Weidle PJ, Everson-Mays RE, et al. Evaluating the cost of medications for ambulatory HIV-infected persons in association with landmark changes in antiretroviral therapy. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 17: 354–60PubMedCrossRefGoogle Scholar
  48. 48.
    Abou-Sayf FK, Marzolf JR. Medical care costs of patients with AIDS in Hawaii. Hawaii Med J 1989; 48: 194–9PubMedGoogle Scholar
  49. 49.
    Beck EJ, Whitaker L, Kennelly J, et al. Changing presentation and survival, service utilization and costs for AIDS patients: insights from a London referral centre. AIDS 1994; 8: 379–84PubMedCrossRefGoogle Scholar
  50. 50.
    Kennelly JM, Tolley KH, Ghani AC, et al. Hospital costs of treating haemophilic patients infected with HIV. AIDS 1995; 9: 787–93PubMedCrossRefGoogle Scholar
  51. 51.
    Nageswaran A, Kinghorn GR, Shen RN, et al. Hospital service utilization by HIV/AIDS patients and their management cost in a provincial genitourinary medicine department. Int J STD AIDS 1995; 6: 336–44PubMedGoogle Scholar
  52. 52.
    Beck EJ, Kupek EJ, Petrou S, et al. Survival and the use and costs of hospital services for London AIDS patients treated with AZT. Int J STD AIDS 1996; 7: 507–12PubMedCrossRefGoogle Scholar
  53. 53.
    Chancellor JV, Hill AM, Sabin CA, et al. Modelling the cost effectiveness of lamivudine/zidovudine combination therapy in HIV infection. Pharmacoeconomics 1997; 12 (1): 54–66PubMedCrossRefGoogle Scholar
  54. 54.
    Brettle RP, Atkinson FI, Wilcock J, et al. The cost of health care for HIV-positive patients. Int J STD AIDS 1997; 8: 50–3PubMedCrossRefGoogle Scholar
  55. 55.
    Beck EJ, Kupek EJ, Wadsworth J, et al. The use and cost of hospital services by London AIDS patients with different AIDS defining conditions. J Public Health Med 1996; 18: 457–64PubMedCrossRefGoogle Scholar
  56. 56.
    Borleffs JC, Jager JC, Poos MJ, et al. Hospital cost for patients with HIV infection in a University Hospital in the Netherlands. Health Policy 1990; 16 (1): 43–54PubMedCrossRefGoogle Scholar
  57. 57.
    Hurley SF, Kaldor JM, Carlin JB, et al. The usage and costs of health services for HIV infection in Australia. AIDS 1995; 9: 777–85PubMedCrossRefGoogle Scholar
  58. 58.
    Peyron F, Flori A, Galliano-di Bernardo Bernardo S, et al. Evaluation of drug use and cost of hospital care for AIDS patients between 1990 and 1994. Pharm World Sci 1997; 19 (4): 202–7PubMedCrossRefGoogle Scholar
  59. 59.
    McDermott J, Williamson E, Wallace E, et al. Hospital outpatient costs for patients with HIV infection. N Z Med J 1991; 104: 43–4PubMedGoogle Scholar
  60. 60.
    Dijkgraaf MG, Luijben AH, Jager JC, et al. In-patient care for symptomatic, HIV-infected persons: a longitudinal study of hospitalizations, in-patient drug use, and related costs. AIDS Care 1995; 7: 321–36PubMedCrossRefGoogle Scholar
  61. 61.
    De Graeve D, Lescrauwaet B, Nonneman W. Patient classification and cost analysis of AIDS and HIV: the case of Belgium. Health Policy 1997; 39: 93–106PubMedCrossRefGoogle Scholar
  62. 62.
    Beck EJ, Tolley K. Financing HIV service provision in England: estimated impact of the cost of antiretroviral combination therapy. Int J STD AIDS 1998; 9: 512–7PubMedCrossRefGoogle Scholar
  63. 63.
    Beck EJ, Tolley K, Power A, et al. The use and cost of HIV service provision in England in 1996. Pharmacoeconomics 1998; 14 (6): 639–52PubMedCrossRefGoogle Scholar
  64. 64.
    Beck EJ, Pozniak A, Molesworth A, et al. Changing cost of English HIV service provision, 1996–1997. Int J STD AIDS 1999; 10: 357–62CrossRefGoogle Scholar
  65. 65.
    Okello DO. Resource utilization patterns in patients with acquired immunodeficiency syndrome (AIDS). East Afr Med J 1994; 71: 816–7PubMedGoogle Scholar
  66. 66.
    Berger R. Cost analysis of AIDS cases in Maryland. Md Med J 1985; 34: 1173–5PubMedGoogle Scholar
  67. 67.
    Scitovsky AA, Cline M, Lee PR. Medical care costs of patients with AIDS in San Francisco. JAMA 1986; 256: 3103–6PubMedCrossRefGoogle Scholar
  68. 68.
    Kaplowitz LG, Turshen IJ, Myers PS, et al. Medical care costs of patients with acquired immunodeficiency syndrome in Richmond, Va. A quantitative analysis. Arch Intern Med 1988; 148: 1793–7PubMedCrossRefGoogle Scholar
  69. 69.
    Kelly JV, Ball JK, Turner BJ. Duration and costs of AIDS hospitalizations in New York. Variations by patient severity of illness and hospital type. Med Care 1989; 27: 1085–98PubMedCrossRefGoogle Scholar
  70. 70.
    Seage GR, Landers S, Barry A, et al. Medical care costs of AIDS in Massachusetts. JAMA 1986; 256: 3107–9PubMedCrossRefGoogle Scholar
  71. 71.
    Johnson AM, Adler MW, Crown JM. The acquired immune deficiency syndrome and epidemic of infection with human immunodeficiency virus: costs of care and prevention in an inner London district. Br Med J (Clin Res Ed) 1986; 293: 489–92CrossRefGoogle Scholar
  72. 72.
    Bjornson DC, Oster CN, Hiner Jr WO, et al. The relationship between outpatient drug costs and disease progression in the human immunodeficiency virus-infected population. DICP 1991; 25 (4): 414–7PubMedGoogle Scholar
  73. 73.
    Chupka LA, Birden HH, Andrews L. Financial aspects of the provision of care to AIDS patients at Hartford Hospital. Conn Med 1992; 56: 467–8PubMedGoogle Scholar
  74. 74.
    Weiss PJ, Kennedy CA, Wallace MR, et al. Medication costs associated with the care of HIV-infected patients. Clin Ther 1993; 15: 912–6PubMedGoogle Scholar
  75. 75.
    Allison-Cooke S. The pattern and cost of hospital care for persons with HIV/AIDS in Guilford County, NC, 1987–1991. N C Med J 1994; 55 (4): 131–4PubMedGoogle Scholar
  76. 76.
    Rosenblum LS, Castro KG, Dooley S, et al. Effect of HIV infection and tuberculosis on hospitalizations and cost of care for young adults in the United States, 1985 to 1990. Ann Intern Med 1994; 121: 786–92PubMedGoogle Scholar
  77. 77.
    Andrulis DP, McGregor CM, Weiss KB, et al. U.S. hospital care for HIV-infected persons and the role of public and private teaching hospitals. J Acquir Immune Defic Syndr Hum Retrovirol 1995; 9: 193–203PubMedGoogle Scholar
  78. 78.
    Fleishman JA, Mor V, Laliberte LL. Longitudinal patterns of medical service use and costs among people with AIDS. Health Serv Res 1995; 30: 403–24Google Scholar
  79. 79.
    Rüttimann S, Tschudi M, Dubach UC. Medical care cost of ambulatory patients infected with the human immunodeficiency virus: analysis at a Swiss outpatient clinic. Eur J Intern Med 1992; 3: 141–6Google Scholar
  80. 80.
    Swaden L, Sabin CA, Phillips AN. CD4 lymphocyte count as a predictor of drug expenditure in a cohort of anti-HIV seropositive haemophiliacs. Int J Pharm Pract 1992; 1: 210–1CrossRefGoogle Scholar
  81. 81.
    Carlsson R, Dickson N, McDermott J, et al. Hospital associated costs of treating patients with AIDS. N Z Med J 1993; 106: 76–8Google Scholar
  82. 82.
    Morton A, McCallum AK, Parkin DW, et al. The patient profile approach to assessing the cost of AIDS and HIV infection. J Publ Health Med 1993; 15: 235–42Google Scholar
  83. 83.
    Peter DL, McDougall M, Maartens G, et al. The cost of adult AIDS inpatient care. S Afr Med J 1994; 84: 447–8PubMedGoogle Scholar
  84. 84.
    Jebakumar SP, Woolley PD, Curless E. Lifetime cost of treating a person with HIV infection. Int J STD AIDS 1995; 6: 444–6PubMedGoogle Scholar
  85. 85.
    Anis AH, Hogg RS, Yip B, et al. Average annual drug cost and its determinants in a population based cohort of HIV-positive adult men and women. Pharmacoeconomics 1998; 13 (3): 327–36PubMedCrossRefGoogle Scholar
  86. 86.
    Gebo KA, Chaisson RE, Folkemer JG, et al. Costs of HIV medical care in the era of highly active antiretroviral therapy. AIDS 1999; 13: 963–9PubMedCrossRefGoogle Scholar
  87. 87.
    Organization for Economic Co-operation and Development (OECD)/CREDES. OECD health data 99: a comparative analysis of 29 countries [CD-ROM]. Paris: OECD/CREDES, 1999Google Scholar
  88. 88.
    Ward D, Brown MA. Labor and cost in AIDS family caregiving. West J Nurs Res 1994; 16: 10–22PubMedCrossRefGoogle Scholar
  89. 89.
    Bowie RD, Tobias MI, Williams T. The private costs of HIV/ AIDS. N Z Med J 1996; 109: 51–4PubMedGoogle Scholar
  90. 90.
    Petrou S, Dooley M, Whitaker L, et al. Cost and utilisation of community services for people with HIV infection in London. Health Trends 1995; 27: 62–8PubMedGoogle Scholar
  91. 91.
    Petrou S, Dooley M, Whitaker L, et al. The economic costs of caring for people with HIV infection and AIDS in England and Wales. Pharmacoeconomics 1996; 9(4): 332–40PubMedCrossRefGoogle Scholar
  92. 92.
    Hansen K, Woelk G, Jackson H, et al. The cost of home-based care for HIV/AIDS patients in Zimbabwe. AIDS Care 1998; 10: 751–9PubMedCrossRefGoogle Scholar
  93. 93.
    Hardy AM, Rauch K, Echenberg D. The economic impact of the first 10,000 cases of acquired immunodeficiency syndrome in the United States. JAMA 1986; 255: 209–11PubMedCrossRefGoogle Scholar
  94. 94.
    Scitovsky AA, Rice DP. Estimates of the direct and indirect costs of acquired immunodeficiency syndrome in the United States, 1985, 1986, and 1991. J Med Pract Manage 1988; 3: 234–41PubMedGoogle Scholar
  95. 95.
    Begley CE, Crane MM, Perdue G. Estimating themortality cost of AIDS: do estimates of earnings differ? Am J Public Health 1990; 80: 1268–70PubMedCrossRefGoogle Scholar
  96. 96.
    Seidman RL, Williams SJ, Mortensen LM. Assessing the economic impact of AIDS in local communities. Current and projected costs for San Diego County. West J Med 1989; 151: 467–71PubMedGoogle Scholar
  97. 97.
    Bozzette SA, Berry SH, Duan N, et al. The care of HIV-infected adults in the United States. HIV Cost and Services Utilization Study Consortium. N Engl J Med 1998; 339: 1897–904PubMedCrossRefGoogle Scholar
  98. 98.
    Herlitz C, Brorsson B. The AIDS epidemic in Sweden: estimates of costs, 1986, 1987 and 1990. Scand J Soc Med 1989; 17: 39–48PubMedGoogle Scholar
  99. 99.
    Postma MJ, Leidl R, Downs AM, et al. Economic impact of the AIDS epidemic in the European Community: towards multinational scenarios on hospital care and costs. AIDS 1993; 7: 541–53PubMedCrossRefGoogle Scholar
  100. 100.
    Pandav CS, Anand K, Shamanna BR, et al. Economic consequences of HIV/AIDS in India. Natl Med J India 1997; 10: 27–30PubMedGoogle Scholar
  101. 101.
    Konde-Lule JK, Sebina AJ. The impact of AIDS in a rural Ugandan community. East Afr Med J 1993; 70: 725–9PubMedGoogle Scholar
  102. 102.
    Farnham PG, Gorsky RD. Costs to business for an HIV-infected worker. Inquiry 1994; 31: 76–88PubMedGoogle Scholar
  103. 103.
    Leigh JP, Lubeck DP, Farnham P, et al. Potential and actual workdays lost among patients with HIV. J Acquir Immune Defic Syndr Hum Retrovirol 1995; 8: 392–8PubMedCrossRefGoogle Scholar
  104. 104.
    Beck EJ, Mandalia S, Williams I, et al. Decreased morbidity and use in hospital services in English HIV infected individuals with increased uptake of anti-retroviral therapy 1996–1997. AIDS 2000; 13: 2157–64CrossRefGoogle Scholar
  105. 105.
    Koopmanschap MA, Rutten FFH, van Ineveld BM, et al. The friction cost method for measuring indirect costs of disease. J Health Econ 1995; 14: 171–89PubMedCrossRefGoogle Scholar
  106. 106.
    Hegarty JD, Abrams EJ, Hutchinson VE, et al. The medical care cost of human immunodeficiency virus-infected children in Harlem. JAMA 1988; 260: 1901–5PubMedCrossRefGoogle Scholar
  107. 107.
    Conviser R, Grant CM, Coye MJ. Pediatric acquired immunodeficiency syndrome hospitilizations in New Jersey. Pediatrics 1991; 87: 642–53PubMedGoogle Scholar
  108. 108.
    Muller C, Fahs MC, Mulak G, et al. Pediatric AIDS at Mount Sinai Medical Center 1988-89: a study of costs and social severity. Soc Work Health Care 1996; 22: 1–20PubMedCrossRefGoogle Scholar
  109. 109.
    Hsia DC, Fleishman JA, East JA, et al. Pediatric human immunodeficiency virus infection: recent evidence on the utilization and costs of health services. Arch Pediatr Adolesc Med 1995; 149: 489–96PubMedCrossRefGoogle Scholar
  110. 110.
    Havens PL, Cuene BE, Holtgrave DR. Lifetime cost of care for children with human immunodeficiency virus infection. Pediatr Infect Dis J 1997; 16: 607–10PubMedCrossRefGoogle Scholar
  111. 111.
    Carlin JB, Langdon P, Hurley SF, et al. Health care and its costs for children with perinatally acquired HIV infection. J Paediatr Child Health 1996; 32: 42–7PubMedCrossRefGoogle Scholar
  112. 112.
    Beck EJ, Mandalia S, Griffith R, et al. Use and cost of hospital and community service provision for children with HIV infection at an English HIV referral centre. Pharmacoeconomics 2000; 17 (1): 53–69PubMedCrossRefGoogle Scholar
  113. 113.
    Nelson E, Weikert M, Phillips JA. Paediatric treatment costs and the HIV epidemic. Cent Afr J Med 1995; 41: 139–44PubMedGoogle Scholar
  114. 114.
    Youle M, Trueman P, Simpson K, et al. Health economics in HIV disease: a review of the European literature. Pharmacoeconomics 1999; 15 Suppl. 1: 1–12PubMedCrossRefGoogle Scholar
  115. 115.
    Hogg RS, O’shaughnessy MV, Gataric N, et al. Decline in deaths from AIDS due to new antiretrovirals [letter]. Lancet 1997; 349: 1294PubMedCrossRefGoogle Scholar
  116. 116.
    Mouton Y, Alfandari S, Valette M, et al. Impact of protease inhibitors on AIDS-defining events and hospitalizations in 10 French AIDS reference centres. Federation National des Centres de Lutte contre le SIDA. AIDS 1997; 11: F101–5PubMedCrossRefGoogle Scholar
  117. 117.
    Wurst J. Health Africa: UN Security Council, breaking tradition, takes up AIDS. Inter Press Service [online]. Available from: URL: http://www.aegis.com/news/ips/2000/IP000105.html2000 [Accessed 2000 Aug 30]Google Scholar
  118. 118.
    Beck EJ, Miners AH. Assessing HIV service provision: why costs are also important. In: Miles A, editor. The effective management of HIV disease. London: Aesculapius Medical Press. In pressGoogle Scholar
  119. 119.
    Direction des Hospitaux, M.S. DMI2: an information system built around the patient. INSERIM — SC4. Paris: Ministere de la Sante et de l’action Humanitaire, 1993Google Scholar
  120. 120.
    Beck EJ. Counting the cost of HIV service provision in England: where do we go from here? J HIV Comb Ther 1997; 2: 29–32Google Scholar

Copyright information

© Adis International Limited 2001

Authors and Affiliations

  • Eduard J. Beck
    • 1
    • 2
  • Alec H. Miners
    • 2
    • 3
  • Keith Tolley
    • 4
  1. 1.Joint Departments of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontrealCanada
  2. 2.NPMS-HHC CAC, St Stephen’s CentreChelsea & Westminster HospitalLondonEngland
  3. 3.Department of Primary Care and Population SciencesRoyal Free and University College Medical SchoolLondonEngland
  4. 4.Department of EconomicsUniversity of NottinghamNottinghamEngland

Personalised recommendations