Author(s)
Stoll M1, Kuhlmann A2, Hower M3, Heiken H4, Gerschmann S1, Klauke S5, Lutz T5, Bogner J6, Degen O7, van Lunzen J7, Bachmann C3, Stellbrink H8, Schmidt W9, Leistner I9, Mahlich JC10, Ranneberg B111Medizinische Hochschule Hannover, Hannover, Germany, 2Leibniz Universität Hannover, Hannover, Germany, 3Klinikum Dortmund, Dortmund, Germany, 4Private Practice, Hannover, Germany, 5Infektiologikum, Frankfurt, Germany, 6Universität München, Munich, Germany, 7Universität Hamburg, Hamburg, Germany, 8ICH Study Center, Hamburg, Germany, 9Ärzteforum Seestrasse, Berlin, Germany, 10Janssen-Cilag GmbH, Neuss, Nordrhein-Westfa, Germany, 11Janssen Cilag, Neuss, Germany
OBJECTIVES: Data on actual cost of illness studies for HIV-infection in Germany are lacking. The objective of CORSAR is to collect comprehensively and prospectively data to calculate direct, indirect and intangible costs in patients receiving ART. METHODS: Multicenter prospective observational study in eight German specialized centres for infectious diseases: four private practices/outpatient centres and four hospitals offering inpatient- and outpatient facilities. CORSAR started recruitment during 2009 and ends in July 2012, when the last patient reaches week 96. After signing informed consent, patients were included and stratified by treatment line. Treatment history and concomitant therapy were taken from the patients’ records. Direct costs for hospitalization, outpatient care, other medical care and treatment as well as out of pocket payments and quality of life data were calculated from the data collected by quarterly questionnaires. RESULTS: A total of 1154 patients with a mean age 47.5y receiving ART were included. Time since HIV-diagnosis was10.6 years, 10.2% had viral load >50 cp/ml; 10.6% female; employment ratio 60.8%. Direct costs of treatment were mainly driven by antiretroviral drugs, accounting for 83.3%. Due to use of less complex ART-regimens and more frequent use of NNRTI-based ART in earlier treatment lines total costs were highest in advanced treatment-lines (>3rd) with 26,243 €/year compared to 22,718 €/year for initial therapy. The labour market participation rate also decreases with advancement in treatment lines (65% in first treatment line vs. 46% in >3rdtreatment lines). Indirect cost due to productivity losses account for 7% of total costs. CONCLUSIONS: Total costs were higher in later lines of therapy due to more complex, less NNRTI-based regimens. In comparison to earlier studies the impact of Non-ART-costs decreased. Expenses to be borne by the patient increased but are still less than 1%, indicating an increasing financial burden of people living with HIV by their disease within the German health system.
Conference/Value in Health Info
2012-11, ISPOR Europe 2012, Berlin, Germany
Value in Health, Vol. 15, No. 7 (November 2012)
Code
PIN33
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine)
