The economic costs of caring for people with HIV infection and AIDS in England and Wales

The objectives of this study were firstly to estimate total lifetime care costs for an individual with HIV/AIDS, and secondly to estimate the total costs of caring for people with HIV infection and AIDS in England and Wales between 1992 and 1997 inclusive. Questionnaires and monthly diaries were used to collate data on healthcare utilisation from patients with HIV over a 6-month period. These data were then used to estimate the annual total direct costs of care (stratified by disease stage), total lifetime costs of care, and present and future total national care costs for England and Wales. Costing data were obtained from providers of services throughout Greater London. In total, 235 patients with HIV infection were recruited from 2 clinics in Greater London. All costs were calculated in 1992-3 pounds sterling ((British-pound; British-pound-1) = $US1.58, December 1995). Annual care costs were estimated at British-pound-4515 ($US7134) for a person with asymptomatic HIV disease, British-pound-8836 ($US13961) for a person with symptomatic non-AIDS and British-pound-15268 ($US24123) for a person with AIDS. Lifetime care costs were estimated at British-pound-84522 ($US133545) per patient. The total costs of care for England and Wales were forecast to increase from British-pound-116400 ($US184271300) in 1992 to British-pound-162638100 ($US256968200) in 1997. In conclusion, our study further emphasizes the continued shift in hospital services from the inpatient sector to the outpatient sector. The importance of community care and informal care, in terms of the associated direct economic costs, is also highlighted. This emphasizes the need for close collaboration between different agencies and strategic coordination of services. Finally, the study forecasts an increase in care costs in England and Wales during the 1990s.