Advertisement

PharmacoEconomics

, Volume 21, Issue 15, pp 1113–1121 | Cite as

Indirect costs in ambulatory patients with HIV/AIDS in Spain

A pilot study
  • Juan OlivaEmail author
  • César Roa
  • Juan del Llano
Original Research Article

Abstract

Objective: To estimate indirect costs in Spanish ambulatory patients with HIV/AIDS and to identify changes in employment status and their current QOL.

Method: Information was obtained through 32 interviews/enquiries carried out with ambulatory patients receiving medical attention at Gregorio Marañón and Puerta de Hierro hospitals in Madrid, Spain. The study variables included information on sociodemographics, economics, and clinical and QOL (EuroQol instrument; EQ-5D) parameters of these patients.

Results: Our main result showed the existence of high indirect costs (lost income and lost wages; 2002 values) at the individual level. We identified a strong effect in terms of income loss (the annual loss of income ranged between €5271 and €6150 per patient) and lost wages (the annual loss of wages ranged between €7537 and €8793 per patient). We also observed a strong impact on household income (the annual loss of household income ranged between €6693 and €7813). There was a great variability in these costs among the patients depending on their QOL, gender and education. We detected a statistically significant and positive correlation between QOL and having a job.

Conclusions: We observed a high level of QOL among the patients, which reflects the potential benefits of pharmacological treatment. We found that the better the QOL, the higher the probability of being employed. However, indirect costs were high among patients despite their good QOL.

Keywords

Labour Market Indirect Cost Annual Loss Income Loss Intangible Cost 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

We would like to thank Indalecio Corugedo, Álvaro Hidalgo, Jaume Puig, Dr Jesús Millán, Dr Emilio Bouza, Dr Dolores Montserrat, Dr Teodoro Martín, Dr María Sanjurjo, Dr Isabel Castillo, Dr Lourdes Caro, Alicia Coduras, Carmen López-Lavid and Gonzalo Nocea and three anonymous referees for their comments.

This study has received unconditional support from Merck, Sharp & Dohme de España, S. A.

Juan Oliva thanks the scholarship granted by The Merck Company Foundation, the philanthropic branch of Merck & Co. Inc., White House Station, New Jersey, USA, for providing the opportunity to attend the congress organised by the Spanish Health Economics Association held in Oviedo in 2001.

The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

References

  1. 1.
    Fauci AS. The AIDS Epidemic: considerations for the 21st century. N Engl J Med 1999; 341: 1046–50PubMedCrossRefGoogle Scholar
  2. 2.
    Casabona J. Sida o infectión por VIH? Implicaciones sanitarias. Med Clin (Bare) 1999; 112: 335–6Google Scholar
  3. 3.
    Ojo K, Delaney M. Economic and demographic consequences of AIDS in Namibia: rapid assessment of the costs. Int J Health Plann Manage 1997; 12: 315–26PubMedCrossRefGoogle Scholar
  4. 4.
    Cabasés Hita JM. Cuánto nos cuesta el Sida? Med Clin (Bare) 1995; 104: 573–5Google Scholar
  5. 5.
    Beck EJ, Miners AIL, Tolley K. The cost of HIV treatment and care: a global review. Pharmacoeconomics 2001 Jan; 19 (1): 13–39PubMedCrossRefGoogle Scholar
  6. 6.
    HIV/AIDS. A threat to decent work, productivity and development (2000). Document for discussion at the Special HighLevel Meeting on HIV/AIDS and the World of Work; 2000 Jun 8; Geneva. ILO (International Labour Organization). SafeWork — Programme on HIV/AIDS. Available from URL: www.ilo.org/public/english/protection/trav/aids/publ/threatdecentworkeng.pdf [Accessed 2003 Aug]
  7. 7.
    Spanish Ministry of Health and Consumer Affairs. Epidemiologia. Available from URL: http://www.mse.es/sida/epidemio-logia/home.htm [Accessed 2003 Aug 6]
  8. 8.
    Castilla J, De la Fuente L. Evolución del número de personas infectadas por el virus de la inmunodeficiencia humana y de los casos de sida en España: 1980–1998. Med Clin (Bare) 2000; 115: 85–9Google Scholar
  9. 9.
    Encuesta hospitalaria sobre la utilización de recursos y caracteristicas de los pacientes VIH/sida. Madrid: Ministerio de Sanidad y Consumo, 1998 NovGoogle Scholar
  10. 10.
    Antonanzas VF, Anton F, Juarez C, et al. Cálculos de los costes del sida en España mediante técnicas de simulación. Med Clin (Bare) 1995; 104: 568–72Google Scholar
  11. 11.
    Mompo C, Abbas I, Santin M, et al. La utilización de recursos sanitarios en pacientes infectados por el VIH: creation de una base de datos y obtención de resultados de costes. Gac Sanit 2000 Enero/febrero; 14 (1): 39–47PubMedGoogle Scholar
  12. 12.
    Pinto JL, Lopez Lavid C, Badia X, et al. Análisis coste efec-tividad del tratamiento antirretroviral de gran actividad en pacientes infectados por el VIII asintomáticos. Med Clin (Bare) 2000; 114 Suppl. 3: 62–7Google Scholar
  13. 13.
    Gebo KA, Chaisson RE, Folkemer JG, et al. Costs of HIV medical care in the era of highly active antiretroviral therapy. AIDS 1999 May 28; 13 (8): 963–9PubMedCrossRefGoogle Scholar
  14. 14.
    Kahn JG, Marseille E. Fighting global AIDS: the value of cost-effectiveness analysis. AIDS 2000 Nov 10; 14 (16): 2609–10PubMedCrossRefGoogle Scholar
  15. 15.
    Lapins DL, Urdaneta ME, Barrett J, et al. Costs of care for HIV infection in a managed care population from 1995 to 1997. Am J Manag Care 2000 Sep; 6 (9): 973–81PubMedGoogle Scholar
  16. 16.
    Wallace MR, Tasker SA, Shinohara YT, et al. The changing economics of HIV care. AIDS Patient Care STDS 2001 Jan; 15 (1): 25–9PubMedCrossRefGoogle Scholar
  17. 17.
    Sendi P, Palmer AJ, Gafni A, et al. Highly active antiretroviral therapy: pharmacoeconomic issues in the management of HIV infection. Pharmacoeconomics 2001; 19 (7): 709–13PubMedCrossRefGoogle Scholar
  18. 18.
    Oliva J. La valoración de los costes indirectos en la evaluation sanitaria. Med Clin (Bare) 2000; 114 Suppl. 3: 15–21Google Scholar
  19. 19.
    Mullins CD, Whitelaw G, Cooke JL, et al. Indirect cost of HIV infection in England. Clin Ther 2000 Nov; 22 (11): 1333–45PubMedCrossRefGoogle Scholar
  20. 20.
    Sendi PP, Bücher HC, Harr T, et al. Cost effectiveness of highly active antiretroviral therapy in HIV-infected patients. AIDS 1999; 13: 1115–22PubMedCrossRefGoogle Scholar
  21. 21.
    Freedberg KA, Losina E, Weinstein MC, et al. The cost effectiveness of combination antiretroviral therapy for HIV disease. N Engl J Med 2001; 344 (11): 824–31PubMedCrossRefGoogle Scholar
  22. 22.
    Johannesson M. The willingness to pay for health changes, the human-capital approach and the external costs. Health Policy 1996; 36: 232–44CrossRefGoogle Scholar
  23. 23.
    Posnett J, Jan S. Indirect cost in economic evaluation: the opportunity cost of unpaid inputs. Health Econ 1996; 5: 13–23PubMedCrossRefGoogle Scholar
  24. 24.
    Pinto JL, Puig-Junoy J. El coste de oportunidad del tiempo remunerado en la production [working paper]. Madrid: Funda-ción BBVA, 2001Google Scholar
  25. 25.
    Liljas B. How to calculate indirect costs in economic evaluation. Pharmacoeconomics 1998; 13 (1): 1–7PubMedCrossRefGoogle Scholar
  26. 26.
    Patella Jr FJ, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 1998; 338 (13): 853–60CrossRefGoogle Scholar
  27. 27.
    Freedberg KA, Losina E, Weinstein MC, et al. The cost effectiveness of combination antiretroviral therapy for HIV disease. N Engl J Med 2001; 344 (11): 824–31PubMedCrossRefGoogle Scholar
  28. 28.
    Canadian Coordinating Office for Health Technology Assessment. Guidelines for economic evaluation of pharmaceutical: Canada. 2nd ed. Ottawa (ON): Canadian Office for Health Technology Assessment (COOHTA), 1997Google Scholar
  29. 29.
    Johannesson M, Jönsson B, Karlsson G. Outcome measurement in economic evaluation. Health Econ 1996; 5: 279–96PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2003

Authors and Affiliations

  1. 1.Department of EconomicsUniversidad Carlos III de MadridGetafe MadridSpain
  2. 2.Fundación Gaspar CasalMadridSpain
  3. 3.Universidad Complutense de MadridMadridSpain

Personalised recommendations