HOSPITAL COSTS OF TREATING HEMOPHILIC PATIENTS INFECTED WITH HIV

Objective: To calculate the costs of treating HIV-infected haemophilic patients. Design: Two-year retrospective study of hospital-based resource use and costs, from April 1991 to March 1993. Setting: Haemophilia Centre and Haemostasis Unit, Royal Free Hospital and School of Medicine, London, UK. Patients: Sixty patients infected with HIV between October 1979 and July 1985. Results: During the 2-year period a total of 1668 hospital visits were made by patients. The mean number of episodes per patient-year (PY) was 0.6 inpatient admissions, 11.5 outpatient visits and 1.8 day cases. The mean cost per PY was pound 32 528, with the majority of this spent on clotting factor concentrate products and haemophilia inpatient admissions (81%). A mean cost for HIV-related treatment of pound 6050 was estimated. The additional cost incurred in switching this group of haemophilic patients from intermediate-purity factor concentrate to high-purity products was pound 8614 per PY. When clotting factor concentrate and expenditure on haemophilia-related inpatient admissions were excluded, the mean cost of treating HIV infection per PY was pound 6065, varying with CD4+ count (less than or equal to 50x10(6)/l, pound 13093; 51-200x10(6)/l, pound 6521; 201-500x 10(6)/l, pound 2848; >501x10(6)/l, pound 1497). Conclusions: CD4+ count may be used as a marker of costs of HIV infection. The HIV-related cost estimates can be used for the planning of current and future hospital-based care in the National Health Service in the United Kingdom. The switch from intermediate-purity factor concentrate to high-purity products has increased the mean HIV-related cost per PY of treating haemophilic patients infected with HIV.