Economic Burden of People Living With HIV in China: An Analysis Based on Real-World Medical Database

OBJECTIVES: This study aims to analyze the direct medical costs among people living with human immunodeficiency virus (PLHIV) in China.

METHODS: We collected the data from a nation-wide registered medical database from 1 January 2018 to 31 December 2020. Patients with HIV infected diagnosis in 2018 and continuous medical records for at least 1 year were included. ·Baseline demographic characteristics and direct medial costs were collected and analyzed. The annual medical costs, medical costs per hospitalization and per outpatient visit were calculated for 2019 and 2020, respectively. Means and standard deviations were estimated for continuous variables while percentages were calculated for categorical variables.

RESULTS: A total of 3,839 PLHIV were included from 10 hospitals with the largest sample sizes. The mean age of PLHIV was 35.8 at the baseline with males accounting for 94%. The mean CD4(+) T cell count was 471.8 at baseline and the CD4(+) T cell counts for most of the patients ranged from 201 to 800 (80.3%). The hospitalization rates were 2.45% and 1.31% in 2019 and 2020. Mean annual total medical costs in 2019 and 2020 were CNY 4,171.6 (SD: 21,530.5) and CNY 2,468.9 (SD: 7,178.0). When calculating for the entire sample, mean annual hospitalization costs were CNY 1,605.8 (SD:19,627.2) and CNY 336.9 (SD: 4,323.0) while mean annual outpatient costs were CNY 2,565.8 (SD: 5,806.5) and CNY 2,132.0 (SD: 4,999.2) in 2019 and 2020, respectively. Mean total medical costs per hospitalization and per outpatient visit in 2019 was also higher than those in 2020 (hospitalization: CNY 30,526.1 vs. CNY 17,894.1; outpatient: CNY 727.8 vs. CNY 509.4).

CONCLUSIONS: People living with HIV in China face with certain economic burden, especially for the hospitalization. Medical costs generated in 2019 are higher than those in 2020 and this may be related to the COVID-19 pandemic.