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November 29, 2006
Psychiatric Disorders Make HIV Treatment Costly (Reuters Health)
Neuropsychiatric disorders (NPD) add substantially to the cost of treatment of HIV-infected patients, according to a report in the October 24th issue of AIDS.
The prevalence of HIV-associated neuropsychiatric disorders continues to rise during the era of highly active antiretroviral therapy (HAART), the authors explain, but few studies have examined the cost trends associated with these disorders.
Dr. Christopher Power from University of Alberta, Edmonton, Alberta, Canada and colleagues examined whether the high costs of managing NPD increased the costs of care among patients with HIV/AIDS.
Costs per month averaged $916.03 Canadian among HIV-infected patients without any NPD, the authors report, compared with C$1612.52 for patients with cognitive impairment, C$1489.91 for patients with peripheral neuropathy, and C$1361.85 for patients with other NPD.
Patients with two or more neuropsychiatric diagnoses faced significantly higher costs than did patients with only one neuropsychiatric diagnosis, the investigators say.
The additional costs were driven by additional clinic visits, physician visits, and non-antiretroviral drugs, the results indicate, as well as 10-fold higher costs for home care.
Costs were also elevated in the 12 months preceding the diagnosis of NPD, the researchers note, with some of the added costs deriving from increased laboratory costs and specialty physician visits.
Total mean costs per month per patient did not differ between NPD and non-NPD groups in the intervals from 12 to 18 months or from 18 to 24 months prior to the diagnosis of NPD, the report indicates.
"We predict that health costs arising from NPD are likely to rise as the use of HAART generates a patient population with HIV/AIDS that has extended life expectancy, necessitating health care planning for these costs," the authors write.
"In future studies," the researchers add, "it might be useful to examine a wider range of NPDs together with the impact of other intercurrent illnesses, including other infections, substance abuse, and other health determinants that influence healthcare costs."
