A MULTI-COUNTRY LIFETIME COST ANALYSIS OF HIV IN 10 LATIN AMERICA COUNTRIES: ARGENTINA, CHILE, COSTA RICA, ECUADOR, EL SALVADOR, GUATEMALA, PANAMA, PERU, URUGUAY, PARAGUAY
Author(s)
Diva Alexandra Barbosa, MSc1, Amilcar Azamar, PhD2, Ruby Chirino-Sprung, MD3, Hugo E. Santana-Santana, Bachelor4, Gibran Sinta Cortes, Bachelor4, Victor Emmanuel Martinez, MSc4, Herman Soto, MSc4.
1Independent consultant, Bogota, Colombia, 2Gilead Sciences Inc, FC, CA, USA, 3Gilead Sciences Mexico, S de RL de CV, Mexico City, Mexico, 4HS Estudios Farmacoeconomicos SA de CV, Mexico City, Mexico.
1Independent consultant, Bogota, Colombia, 2Gilead Sciences Inc, FC, CA, USA, 3Gilead Sciences Mexico, S de RL de CV, Mexico City, Mexico, 4HS Estudios Farmacoeconomicos SA de CV, Mexico City, Mexico.
OBJECTIVES: HIV remains a critical public health challenge across Latin America, with heterogeneity in both epidemiological patterns and healthcare infrastructure among nations. While treatment costs vary substantially, traditional cost analyses focusing only on antiretroviral therapy expenditures provide an incomplete picture of HIV's true economic impact. This multi-country study quantifies comprehensive lifetime and annual per-person costs across 10 Latin American countries, capturing both direct medical expenses and broader societal burden to inform regional prevention strategies.
METHODS: This study used a standardized cost-of-illness framework across all countries using dual perspectives. The healthcare system perspective included antiretroviral procurement and administration, clinical monitoring stratified by immunological status, and management of opportunistic infections. The societal perspective incorporated productivity losses, years of life lost due to premature mortality, and informal caregiving burden. Country-specific survival estimates post-diagnosis informed lifetime calculations. Costs were standardized to 2024 USD. All information used in the analysis was sourced from public and open-access sources.
RESULTS: Estimated direct lifetime costs per PLWH and corresponding annual costs vary by country: Argentina $521,100 and $11,328; Chile $237,985 and $4,958; Costa Rica $568,736 and $11,375; Ecuador $90,620 and $2,014; El Salvador $58,499 and $1,393; Guatemala $363,918 and $9,836; Panama $41,550 and $923; Peru $22,811 and $507; Uruguay $339,790 and $8,288; Paraguay $112,273 and $2,673. Additional indirect costs, including productivity losses, premature mortality, and informal care, further increase the financial burden.
CONCLUSIONS: This regional analysis displayed that despite ten-fold variation in treatment costs across Latin American countries, the economic burden of HIV extends far beyond medical care. Whether in high-cost or low-cost treatment environments, indirect costs dominate. These findings emphasize that sustainable HIV economic control requires robust prevention programs to reduce new infections, not only treatment cost optimization. Regional policymakers should prioritize comprehensive prevention strategies such as targeted testing, pre-exposure prophylaxis scale-up, and community interventions; tailored to each country's epidemic profile.
METHODS: This study used a standardized cost-of-illness framework across all countries using dual perspectives. The healthcare system perspective included antiretroviral procurement and administration, clinical monitoring stratified by immunological status, and management of opportunistic infections. The societal perspective incorporated productivity losses, years of life lost due to premature mortality, and informal caregiving burden. Country-specific survival estimates post-diagnosis informed lifetime calculations. Costs were standardized to 2024 USD. All information used in the analysis was sourced from public and open-access sources.
RESULTS: Estimated direct lifetime costs per PLWH and corresponding annual costs vary by country: Argentina $521,100 and $11,328; Chile $237,985 and $4,958; Costa Rica $568,736 and $11,375; Ecuador $90,620 and $2,014; El Salvador $58,499 and $1,393; Guatemala $363,918 and $9,836; Panama $41,550 and $923; Peru $22,811 and $507; Uruguay $339,790 and $8,288; Paraguay $112,273 and $2,673. Additional indirect costs, including productivity losses, premature mortality, and informal care, further increase the financial burden.
CONCLUSIONS: This regional analysis displayed that despite ten-fold variation in treatment costs across Latin American countries, the economic burden of HIV extends far beyond medical care. Whether in high-cost or low-cost treatment environments, indirect costs dominate. These findings emphasize that sustainable HIV economic control requires robust prevention programs to reduce new infections, not only treatment cost optimization. Regional policymakers should prioritize comprehensive prevention strategies such as targeted testing, pre-exposure prophylaxis scale-up, and community interventions; tailored to each country's epidemic profile.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
P36
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Reproductive & Sexual Health