£1bn UK HIV Care Costs

posted: 24/01/2011

The cost of providing HIV treatment in the UK could reach £758 million by 2013. Adding HIV social care costs to this total means the total state spending on HIV care could be over £1 billion a year in 2013.
 

The UK has the fastest growing HIV epidemic in Europe, with rising numbers using NHS HIV services. People are continuing to get HIV, and because modern HIV treatments work so well, few are dying early. Both of these trends increase the total cost of HIV care, every year.
 

Annual costs from 1997

The study looked at how much it cost the NHS to provide treatment and care to people with HIV between 1997 and 2006. They also calculated the costs for future years, to 2013.
 

Using information from 14 clinics, they divided people up, depending on the stage of their HIV illness (no symptoms; with illness symptoms; an AIDS diagnosis), and their HIV treatment. They used routinely collected NHS HIV service use data to work out typical care for the different stages of HIV illness.
 

Triple the people, quadruple the bill
The total using NHS HIV services tripled from near 17,000 in 1997 to just over 52,000 in 2006. At the same time, the cost of treatment and care more than quadrupled from £104 million in 1997 to £483 million in 2006.
 

Social Care
Adding in social and community care costs increases the total health and social care costs from £104 to £164 million in 1997, and from £483 to £683 million in 2006.
 

The proportion of the money spent on treatment rose between 1997 and 2006, but spending on social care fell.

Treatment cost between £18,000 to £41,000 a year
In 2006, medical care and HIV treatments costs just over £18,000 for each person without symptoms, £21,500 for people with HIV symptoms, and over £41,000 for people with AIDS.
 

Estimating future costs
By 2013 the researchers estimate there will be 78,370 people using NHS HIV clinics, with their treatment and care costing between £720 million and £758 million.

Adding in social and community care costs raises the total state spending on HIV treatment and care in the UK to as much as £1,065 million.
 

“The direct cost for treatment and care for PLWHIV [people living with HIV] has risen 4.6 fold between 1997 and 2006,” say the investigators, with costs projected to increase “1.5 fold” between 2007 and 2013.
 

What’s pushing up costs?
People should start HIV treatment by the time their CD4 count has fallen to around 350. But late diagnosis is a major problem in the UK and this means many people start treatment late, which is always much more expensive. There’s now a national target to reduce late diagnosis, and this will increase the number of people on HIV treatment and therefore the total bill. But the researchers believe that this is well worth it.

“Starting PLWHIV on cost-effective regimens earlier, will maintain them in better health, resulting in fewer health or social services and thereby generating fewer treatment and care costs, while enabling them to remain socially and economically active members of society.”
 

Cut the bill – spend to prevent HIV
The continuing rise in HIV treatment and care costs really matters when the NHS and council social care budgets are being cut. The authors say trimming the amount it costs for each person would probably worsen HIV patient care, and save little.
 

Instead they say invest more in prevention, to reduce the number of new people needing HIV treatment every year. “Only comprehensive prevention strategies, responding directly to the epidemic dynamics operating in each country, will be able to reduce HIV incidence,” they argue.
“Policy makers and other relevant stakeholders need to use evidence-informed HIV prevention, treatment and care strategies…which will prolong life, reduce morbidity and ultimately deliver the best for both the individual and public health agendas.”
 

Source, with reference 

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