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An American found to have the virus that causes AIDS can expect to live for about 24 years on average, and the cost of health care over that time is more than $600,000, new research indicates.
Both life expectancy and the cost of care have risen from earlier estimates, mainly because of expensive and effective drug therapies, said Bruce Schackman, an assistant professor of public health at the Weill Medical College of Cornell University in New York and the study's lead author.
The research found the average annual cost of care was $25,200, about 40% higher than a commonly cited estimate from the late 1990s. A 1993 estimate of life expectancy for a symptomless person infected with HIV was less than seven years.
The new study appears in the November edition of the peer-reviewed journal Medical Care.
Since the mid 1990s, about two dozen HIV-fighting antiretroviral drugs have come onto the market that have essentially turned the virus from a death sentence into a chronic disease.
Physicians now understand life expectancy after HIV diagnosis to be two decades or more, and the new study supports that belief.
The researchers drew most of their data from 18 medical practices across the United States that provide care for 14,000 patients. The researchers looked at the records of about 7,000 of those patients.
They used a computer simulation model to project HIV medical care costs and concluded that the average lifetime cost of care was $618,000 per person. The researchers estimated the monthly cost of care at $2,100, with about two thirds of that spent on medications. That equates to $25,200 a year.
A typical regimen for an HIV patient beginning treatment includes the drug efavirenz, which blocks a certain protein that HIV needs to make copies of itself. It also includes tenofovir and emtricitabine or some similar drug that helps keep the virus from reproducing.
The monthly cost just for that regimen was about $1,140 in 2004, Schackman and the other researchers said. If that treatment does not work or stops working, the patient is switched to more expensive arrays of drugs.
In their cost estimates, the researchers aimed high, basing their numbers on the best available drugs and the best standards of care. But that is not always what is provided, some HIV policy experts noted.
For example, a 2003 federal study concluded that only 55% of HIV patients who should have been on virus-fighting medications were actually getting them.
"This is really an optimistic scenario" in the study, and the true cost is probably lower, said Jennifer Kates, director of HIV policy for the Kaiser Family Foundation.
However, Kates added that since people living with HIV should be getting optimal care from doctors experienced in treating the virus, the study's expectations were reasonable. (AP)