About AIDS

The new anti-HIV drugs that have come out in the past five years have dramatically reduced progression to AIDS and death, but people are often shocked at how much they cost - around $15,000 a year just for the pills. However, a pair of studies published in the New England Journal of Medicine (March 15, 2001) confirms what a UT medical school had demonstrated over a year ago: They may be expensive, but the drugs are cost-effective because they help keep people out of the hospital, thus reducing overall patient care costs. They also increase life expectancy from 1.5 to 2.9 years.

Keeping people alive and in better health has reduced annual overall HIV care cost per patient, including inpatient and outpatient care, by 16% (to $18,300) between 1996 and 1998. It may sound like a lot, but such a cost is in line with treating other diseases like diabetes, kidney disease, and many cancers.

For those who have begun the treatments, improved health and survival depend on "adherence" to the pill regimen, essentially taking every dose, every day, nearly perfectly. The study observes, however, that as people are having trouble staying with the complex programs, treatment failures are mounting. Here in Austin, AIDS Services of Austin heads a collaboration called the BOSS project to assist HIV-positive African-Americans in getting (and sticking with ) the care that's available. In addition, Austin's respected David Powell Clinic is working with ASA and others to devise an adherence assistance program.

The numbers are encouraging, both in cost-benefit analysis and in improving people's lives. As Kenneth Freedberg, MD, study director at Mass Gen notes,"There aren't a lot of things that we treat that are a lot more cost effective than this."