Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in Taiwan
Since the late 1980s, the Taiwanese government has provided all HIV-infected citizens with free access to antiretroviral therapy. Recently, there is controversy as to whether or not free access to expensive highly active antiretroviral therapy (HAART) should be continued for HIV-infected patients. T...
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| Format: | Article |
| Language: | English |
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Elsevier
2007-08-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664608600200 |
| _version_ | 1828853847656759296 |
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| author | Chi-Tai Fang Yu-Yin Chang Hsu-Mei Hsu Shiing-Jer Twu Kow-Tong Chen Mao-Yuan Chen Loreen Y.L. Huang Jing-Shiang Hwang Jung-Der Wang |
| author_facet | Chi-Tai Fang Yu-Yin Chang Hsu-Mei Hsu Shiing-Jer Twu Kow-Tong Chen Mao-Yuan Chen Loreen Y.L. Huang Jing-Shiang Hwang Jung-Der Wang |
| author_sort | Chi-Tai Fang |
| collection | DOAJ |
| description | Since the late 1980s, the Taiwanese government has provided all HIV-infected citizens with free access to antiretroviral therapy. Recently, there is controversy as to whether or not free access to expensive highly active antiretroviral therapy (HAART) should be continued for HIV-infected patients. This study aimed to evaluate the cost-effectiveness of HAART therapy.
Methods: HAART-associated improvement in survival was obtained by analyzing the follow-up data of all HIV-positive patients identified during April 1984 to March 1997 (pre-HAART era) and May 1997 to April 2003 (HAART era) in Taiwan. Data on quality of life in HIV-positive patients was obtained from a cross-sectional survey of 224 patients using standard gamble method and World Health Organization Quality of Life-BREF instrument. Information regarding the cost of HAART was obtained from the National Health Insurance (NHI).
Results: In 2000, the average annual NHI expenditure on HAART per HIV-positive patient receiving HAART was NT$210,018 (US$6177, at an exchange rate of 34.0 NT$/US$). In the AIDS group, the cost was NT$176,441 (US$5189) per life year gained and NT$241,700 (US$7109) per quality-adjusted life year gained. For non-AIDS patients, the corresponding costs were NT$226,156 (US$6652) and NT$332,582 (US$9782), respectively. These estimates have not yet included the additional cost savings from HAART-associated reduction in hospitalization and use of antimicrobial agents for opportunistic infections, and the additional life years gained from the reduction in HIV transmission under the universal availability of HAART
Conclusion: HAART for HIV infection is cost-effective, especially when the societal and epidemiologic factors are considered. We recommend that the policy of providing free HAART to all HIV-infected citizens be continued. |
| first_indexed | 2024-12-13T00:22:17Z |
| format | Article |
| id | doaj.art-f5f1a9e874774b4480beb48817319a1c |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-13T00:22:17Z |
| publishDate | 2007-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-f5f1a9e874774b4480beb48817319a1c2022-12-22T00:05:33ZengElsevierJournal of the Formosan Medical Association0929-66462007-08-01106863164010.1016/S0929-6646(08)60020-0Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in TaiwanChi-Tai Fang0Yu-Yin Chang1Hsu-Mei Hsu2Shiing-Jer Twu3Kow-Tong Chen4Mao-Yuan Chen5Loreen Y.L. Huang6Jing-Shiang Hwang7Jung-Der Wang8Department of Internal Medicine, National Taiwan University Hospital, TaiwanCollege of Public Health, National Taiwan University, TaiwanDepartment of Health, Executive Yuan, TaiwanCollege of Public Health, National Taiwan University, TaiwanDepartment of Public Health, College of Medicine, National Cheng Kung University, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, TaiwanCollege of Public Health, National Taiwan University, TaiwanInstitute of Statistical Science, Academia Sinica, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, TaiwanSince the late 1980s, the Taiwanese government has provided all HIV-infected citizens with free access to antiretroviral therapy. Recently, there is controversy as to whether or not free access to expensive highly active antiretroviral therapy (HAART) should be continued for HIV-infected patients. This study aimed to evaluate the cost-effectiveness of HAART therapy. Methods: HAART-associated improvement in survival was obtained by analyzing the follow-up data of all HIV-positive patients identified during April 1984 to March 1997 (pre-HAART era) and May 1997 to April 2003 (HAART era) in Taiwan. Data on quality of life in HIV-positive patients was obtained from a cross-sectional survey of 224 patients using standard gamble method and World Health Organization Quality of Life-BREF instrument. Information regarding the cost of HAART was obtained from the National Health Insurance (NHI). Results: In 2000, the average annual NHI expenditure on HAART per HIV-positive patient receiving HAART was NT$210,018 (US$6177, at an exchange rate of 34.0 NT$/US$). In the AIDS group, the cost was NT$176,441 (US$5189) per life year gained and NT$241,700 (US$7109) per quality-adjusted life year gained. For non-AIDS patients, the corresponding costs were NT$226,156 (US$6652) and NT$332,582 (US$9782), respectively. These estimates have not yet included the additional cost savings from HAART-associated reduction in hospitalization and use of antimicrobial agents for opportunistic infections, and the additional life years gained from the reduction in HIV transmission under the universal availability of HAART Conclusion: HAART for HIV infection is cost-effective, especially when the societal and epidemiologic factors are considered. We recommend that the policy of providing free HAART to all HIV-infected citizens be continued.http://www.sciencedirect.com/science/article/pii/S0929664608600200cost-effectivenessHAARThealth policyhighly active antiretroviral therapyHIV infection |
| spellingShingle | Chi-Tai Fang Yu-Yin Chang Hsu-Mei Hsu Shiing-Jer Twu Kow-Tong Chen Mao-Yuan Chen Loreen Y.L. Huang Jing-Shiang Hwang Jung-Der Wang Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in Taiwan Journal of the Formosan Medical Association cost-effectiveness HAART health policy highly active antiretroviral therapy HIV infection |
| title | Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in Taiwan |
| title_full | Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in Taiwan |
| title_fullStr | Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in Taiwan |
| title_full_unstemmed | Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in Taiwan |
| title_short | Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in Taiwan |
| title_sort | cost effectiveness of highly active antiretroviral therapy for hiv infection in taiwan |
| topic | cost-effectiveness HAART health policy highly active antiretroviral therapy HIV infection |
| url | http://www.sciencedirect.com/science/article/pii/S0929664608600200 |
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