Determinants of Direct Costs of HIV-1 Outpatient Care in Israel

Tom Rom, Itzchak Levy, Saritte Perlman, Tomer Ziv-Baran and Orna Mor ()
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Tom Rom: School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
Itzchak Levy: Infectious Disease Unit, Sheba Medical Center, Ramat Gan 52621, Israel
Saritte Perlman: School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
Tomer Ziv-Baran: School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
Orna Mor: School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel

IJERPH, 2022, vol. 19, issue 21, 1-11

Abstract: HIV-1 patients place an economic burden on the health system. The objectives of this study were to estimate the direct HIV-1 costs and cost-related factors of HIV-1 patients in Israel and identify cost predictors. We conducted a retrospective study of randomly selected HIV-1 patients aged ≥18 who visited a large outpatient clinic in 2015 and/or 2019. Yearly costs of physician and nurse visits, antiretroviral therapy (ART) and laboratory tests were calculated in USD using the 2020 purchasing power parities. Associations between disease characteristics and costs were analyzed using univariate and multivariable analysis. The median (IQR) total direct costs per patient per year were USD 12,387 (9813–14,124) and USD 12,835 (11,651–13,970) in 2015 ( n = 284) and 2019 ( n = 290), respectively. ART accounted for approximately 77% of all direct costs, followed by laboratory tests (20%) and medical visits (3%) in both studied years. Being female (USD +710), first yearly viral load <50 c/mL (+$1984) and ≥20 years with HIV-1 (USD +1056) were independently associated with higher costs. In conclusion, HIV-1 cost was stable in the studied period. Viral load and time since diagnosis were the major determinants associated with HIV-1 costs. ART and laboratory tests accounted for 97% of the costs. Therefore, these factors should be considered when planning future expenditures.

Keywords: HIV-1; cost-prediction; Israel; economic burden (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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