ArticleAIDS (London, England)2019
Heterogeneity in the costs of medical care among people living with HIV/AIDS in the United States.
Article in AIDS (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Barriers and pathways to re-engage people with HIV and substance use in medical care: a qualitative study among persons with lived experience.AIDS research and therapy · 2025Article
- Cost-Effectiveness Analysis Combining Medical and Mental Health Services for Older Adults with HIV in New York City.Atlantic economic journal : AEJ · 2021Article
- Developing a dynamic HIV transmission model for 6 U.S. cities: An evidence synthesis.PloS one · 2019Article
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Authors and funding
7 authors.
Funding
Abstract
objectiveThe costs of medical care for people with HIV/AIDS (PWH) vary substantially across demographic groups, stages of disease progression and regionally across the United States. We aimed to estimate medical costs for PWH and examine the heterogeneity in costs within key patient groups typically distinguished in cost-effectiveness analyses.
designRetrospective cohort study using health administrative databases for diagnosed PWH in care at 17 HIV Research Network sites across the United States.
methodsWe estimated mean quarterly costs for key patient groups using multivariable generalized linear mixed effects models. We used quantile regression to highlight differences in the effect of covariates within each patient group (difference between covariate estimates at the mean versus the 90th percentile of quarterly costs), identifying covariates with a larger effect among the highest cost PWH, or generating greater uncertainty in mean cost estimates.
resultsOur sample included 40 022 patients with a median age of 39 years. Mean quarterly costs were highest for people who inject drugs with advanced disease progression and for PWH on antiretroviral treatment (ART). Within patient groups, we found the most heterogeneity at different levels of resource use for PWH on ART and PWH off ART with CD4 cell counts less than 200 cells/μl, people who inject drugs, as well as PWH in the South.
conclusionThe study quantifies heterogeneity in costs both across and within key PWH patient groups. Our results highlight the need for sensitivity analysis on cost estimates and may inform decisions on model structure in cost-effectiveness analyses on HIV/AIDS treatment and prevention strategies.
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