OBJECTIVES : Cachexia is a syndrome consisting of muscle fatigue, weakness, and weight loss most commonly existing within a comorbid disease such as later stages of HIV or cancer. Cachexia has been linked to increased healthcare utilization, decreased life expectancy, and worsening prognosis. Anabolic steroids and human growth hormone (combined term growth factor (GF)) are treatment options for cachexia, but are themselves controversial due to side effect potentials. The goal of this analysis is to assess the impact of GF treatment healthcare utilization and cost in HIV related cachexia patients.

METHODS : Using a large retrospective claims dataset we identified cachectic HIV patients, dividing them into GF and non-GF groups. We compared the two groups on overall utilization and cost as well as antibiotic use and days supply(DS) of antibiotic. Descriptive statistics included t-tests and chi-square. Logistic regression was used to compare odds of hospitalization, ER, and antibiotic while controlling for significant comorbid diseases.

RESULTS : 330 cachectic HIV patients were identified, 54 in the GF group and 276 in the non-GF group. On average, GF patients had significantly less emergency room visits (0.574 GF vs 1.768 NGF, p<0.01) and hospitalizations (0.222 vs 1.304 p<0.01). Mean and median antibiotics DS was high, but not significantly different (120.65 vs 164.33, p=0.24; 31.5 vs 59.5 p=0.26, respectively). Median all-cause cost ($54,281 vs $34,849 p=0.01) and outpatient costs ($52,414 vs $21,680 p<0.01) were higher for the GF group, but mean hospital cost ($2,692 vs $29,145 p<0.01) was lower. After controlling for comorbid diseases, the odds of a hospitalization were 69.5% less (p=0.01) for GF patients.

CONCLUSIONS : It is of interest that while the GF group had significantly less ER visits and hospitalizations the overall cost for this group was still significantly higher. Further analysis needs to explore the sources of these outpatient costs and discuss their relevance within the disease.