OBJECTIVES

: With highly effective antiretroviral therapy and increasing life-expectancy, it is common that HIV-infected patients are increasingly being diagnosed with non-communicable diseases, especially cardiovascular diseases (CVDs). This phenomenon is not only a disease burden but also drives an increase in medical expenditures. This population-based study aims to estimate the burden of medical costs associated with CVDs among HIV-infected patients in Taiwan.

METHODS

: The National Health Insurance Research Database 2001-2011 were utilized. The detailed data including inpatient, outpatient, and pharmacy records were obtained from 12,457 HIV-infected patients with a total of 59,083 person-years of follow-up. The direct medical costs were estimated from the patients followed up for at least 3 years. The yearly costs associated with individual CVDs were evaluated and adjusted using a generalized estimating equational model. All cost values are presented as United States dollars (USD) in year 2016.

RESULTS

: The mean age of study patients was 33.77 ± 9.24 and 90.5% of them were male. The annual direct medical costs for male HIV patients aged between 45 and 64 without any complications and comorbidities (e.g., CVDs) were $2,155.6 USD (baseline costs). Heart failure, ischemic heart diseases and atrial fibrillation events were associated with 72 ~ 137 % increases in medical costs (i.e., $2,155.6 USD x 1.72 ~ 2.37), whereas the medical costs of the patients with acute myocardial infarction and stroke event increased by 39 and 467 %, respectively (i.e., $2,155.6 USD x 1.39 ~ 5.67), comparing to those without these CVD events.

CONCLUSIONS

: This is the first study estimating the direct medical costs associated with CVDs among HIV-infected population in Taiwan. The results are relevant in the future to understand the financial implications of an increasingly aging HIV-infected population.