Defining a Global Disease Budget for HIV in Greece

OBJECTIVES: A global, dynamic, closed budget for HIV has long been considered a pathway to efficiency and sustainability in funding a chronic infectious disease that remains a public health priority. We aim to explore for the first time a methodological approach to facilitate the definition of such a budget in Greece.

METHODS: We built a custom disease global budget calculator for the year 2020 as our base. We modelled HIV clinical management, based on diagnostic tests from the official HIV Diagnostic Guidelines (2022) and HIV Standards of Care (SoC) (2022) of the Hellenic Society for the Study and Control of AIDS (EEMAA), and antiretroviral treatment (ART), after processing data from an HIV panel survey from IQVIA (2020 – 2022). Epidemiological surveillance data were derived from the National Public Health Organization for 2020 and 2021, while projections were made for 2022 based on averages of 5-year historic data. Diagnostic and laboratory tests’ costs were based on the National Organization for Healthcare Services Provision (EOPYY) tariff. Medicinal products’ costs (invoice prices) were calculated from the Official Price Bulletins of the respective year (2019-2022). Both cost categories exclude any voluntary discounts and mandatory paybacks. Hospitalizations were not modelled, as they constitute a negligible part of HIV-related expenditure in Greece.

RESULTS: Our model calculations for 2020 indicate that HIV patients on treatment increase by 533 people, whilst mean annual per patient costs, including new diagnoses, decline from €7,522 in 2020 to €7,205 in 2022, a 4.2% decline. Diagnostic and laboratory tests account for 5.5% of total costs with the remaining referring to ART.

CONCLUSIONS: Our study provides a methodology and a tool to support the definition of global, dynamic budgets for health conditions that are well managed, i.e., monitored through a comprehensive patient registry and managed through diagnostic and treatment protocols, and agreed SoC.