HIV LIFETIME AND ANNUAL COSTS IN BRAZIL
Author(s)
Rafael Anunciação, MSc1, Amilcar Azamar, PhD2, Ruby Chirino-Sprung, MD3, Hugo E. Santana-Santana, Bachelor4, Gibran Sinta Cortes, Bachelor4, Victor E. Martinez, MSc4, Herman Soto, MSc4;
1Gilead Sciences Farmaceutica do Brasil Ltda, SP, Brazil, 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
1Gilead Sciences Farmaceutica do Brasil Ltda, SP, Brazil, 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: Brazil faces a persistent HIV epidemic, with 1.06 million people living with HIV and approximately 39,000 new diagnoses annually. While Brazil's universal access policy for generic antiretroviral therapy has kept drug acquisition costs relatively low, the economic burden of the HIV epidemic extends beyond treatment expenses and encompasses a broader range of impacts. This study quantifies comprehensive lifetime and annual HIV per-person costs in Brazil, capturing both treatment expenses and broader societal burden to inform HIV policy interventions.
METHODS: We conducted a cost-of-illness analysis from two perspectives. The healthcare system perspective included antiretroviral procurement (predominantly generic formulations), clinical monitoring stratified by CD4 count, and management of opportunistic infections. The societal perspective added indirect costs: productivity losses from disability and premature death, years of life lost (YLL), and informal caregiving burden. Cost estimates assumed 49-year average survival post-diagnosis. All costs were expressed in 2024 USD. All information used in the analysis was sourced from public and open-access sources.
RESULTS: Healthcare system costs totaled $44,110 per lifetime ($900 annually). Despite generic ART utilization keeping medication costs modest, indirect costs dominated the economic picture at $253,822 lifetime ($5,180 annually)—representing 85% of total burden. Total lifetime cost per person reached $297,932. Productivity losses accounted for around 70% of the indirect costs (, with premature mortality contributing substantially given Brazil's relatively young HIV-affected population.
CONCLUSIONS: This analysis reveals that, while generic medications have successfully reduced direct treatment costs, Brazil's high HIV incidence generates substantial ongoing economic burden. With nearly 39,000 new diagnoses yearly, the indirect costs far exceed medical expenditure. These findings emphasize that controlling HIV's economic impact requires aggressive prevention strategies to reduce new infections, not merely cost-effective treatment policies. Policymakers should redirect resources toward comprehensive prevention programs, including targeted testing in high-risk populations, pre-exposure prophylaxis expansion, and community-based interventions addressing transmission drivers.
METHODS: We conducted a cost-of-illness analysis from two perspectives. The healthcare system perspective included antiretroviral procurement (predominantly generic formulations), clinical monitoring stratified by CD4 count, and management of opportunistic infections. The societal perspective added indirect costs: productivity losses from disability and premature death, years of life lost (YLL), and informal caregiving burden. Cost estimates assumed 49-year average survival post-diagnosis. All costs were expressed in 2024 USD. All information used in the analysis was sourced from public and open-access sources.
RESULTS: Healthcare system costs totaled $44,110 per lifetime ($900 annually). Despite generic ART utilization keeping medication costs modest, indirect costs dominated the economic picture at $253,822 lifetime ($5,180 annually)—representing 85% of total burden. Total lifetime cost per person reached $297,932. Productivity losses accounted for around 70% of the indirect costs (, with premature mortality contributing substantially given Brazil's relatively young HIV-affected population.
CONCLUSIONS: This analysis reveals that, while generic medications have successfully reduced direct treatment costs, Brazil's high HIV incidence generates substantial ongoing economic burden. With nearly 39,000 new diagnoses yearly, the indirect costs far exceed medical expenditure. These findings emphasize that controlling HIV's economic impact requires aggressive prevention strategies to reduce new infections, not merely cost-effective treatment policies. Policymakers should redirect resources toward comprehensive prevention programs, including targeted testing in high-risk populations, pre-exposure prophylaxis expansion, and community-based interventions addressing transmission drivers.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE73
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Reproductive & Sexual Health