Evidence map›Paper›PMID 30189882›Full record

Observational studyBMC health services research2018

How has the cost of antiretroviral therapy changed over the years? A database analysis in Italy.

Lucia Taramasso, Federica Demma, Rossella Bitonti, Antonio Ferrazin, Barbara Giannini, Mauro Giacomini, Sabrina Beltramini, Elisabetta Sasso, Claudio Viscoli, Antonio Di Biagio

Abstract readObservational Study
In one paragraph

Observational study in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lucia TaramassoInfectious Diseases Unit, University of Genova (DISSAL), Policlinico Hospital San Martino, Genoa, Italy.
Federica DemmaEBMA Consulting, Melegnano, Milan, Italy.
Rossella BitontiEBMA Consulting, Melegnano, Milan, Italy.
Antonio FerrazinInfectious Diseases Unit, Department of Internal Medicine, Policlinico Hospital San Martino, Genoa, Italy.
Barbara GianniniDepartment of Informatics Bioengineering, Robotics, and Systems Engineering (DIBRIS), University of Genova, Genoa, Italy.
Mauro GiacominiDepartment of Informatics Bioengineering, Robotics, and Systems Engineering (DIBRIS), University of Genova, Genoa, Italy.
Sabrina BeltraminiDepartment of Pharmacy, Policlinico Hospital San Martino, Genoa, Italy.
Elisabetta SassoDepartment of Pharmacy, Policlinico Hospital San Martino, Genoa, Italy.
Claudio ViscoliInfectious Diseases Unit, University of Genova (DISSAL), Policlinico Hospital San Martino, Genoa, Italy.
Antonio Di BiagioInfectious Diseases Unit, Department of Internal Medicine, Policlinico Hospital San Martino, Genoa, Italy. antonio.dibiagio@hsanmartino.it.ORCID http://orcid.org/0000-0003-1436-5089

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe number of human immunodeficiency virus (HIV)-related hospitalizations has decreased worldwide in recent years, due to the availability of combined antiretroviral therapies (cART). The present analysis aimed to analyse the economic, and clinical burden of HIV management, after the introduction of systematic use of cART.

methodsData from HIV-infected patients, treated at Policlinico San Martino Hospital in Genova (Italy) were retrospectively collected. A comparison between years 2009 and 2015 was performed. HIV-related admissions were identified by using the Diagnosis-Related Group (DRG) codes. The resource consumption of outpatient services was derived by using a modelling approach. Expenditure for drugs was also analysed, as aggregate data.

resultsThe number of HIV-infected patients was 898 in 2009 and 1006 in 2015. Overall, the virological success rate improved from 2009 to 2015, as the percentage of patients with HIV-RNA < 50 copies/mL increased from 79 to 89% (P < 0.05). The average incidence of hospitalizations per-patient decreased from 0.30 in 2009, to 0.13 in 2015. Average expenditure per-patient decreased from €10,107 in 2009 to €9063 in 2015.

conclusionsThe present analysis confirmed the role of cART in controlling HIV viral load and, consequently, in reducing hospitalizations, admissions to day-hospital and the use of outpatient services. Clinical improvements and economic savings more than compensated the investments required to treat HIV-infected patients with cART. Health Authorities should invest in modern cART supply and universal treatment, to use at best the available resources and obtain a cost-effective improvement of health in people living with HIV. Additional research, with the involvement of different centers and the use of patient-specific data, are recommended to consolidate the findings of this analysis.

Indexed as

Ambulatory CareAnti-HIV AgentsCD4 Lymphocyte CountDatabases, FactualDrug Therapy, CombinationFemaleHIV InfectionsHospitalizationHumansItalyMaleMiddle AgedRetrospective StudiesViral LoadAnti-HIV AgentsAIDSAntiretroviralBurdencARTCostHIVHospitalization

Identifiers

PMID30189882
PMCPMC6127985

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.