Forecast model for the evaluation of economic resources employed in the health care of patients with HIV infection

Paolo Sacchi¹, Savino FA Patruno¹, Raffaele Bruno¹, Serena Maria Benedetta Cima¹, Pietro Previtali², Alessia Franchini², Luca Nicolini³, Carla Rognoni⁴, Lucia Sacchi⁵, Riccardo Bellazzi⁴, Gaetano Filice<sup>1

1</sup>Divisione di Malattie Infettive e Tropicali - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; ²Università degli Studi di Pavia – Facoltà di Economia, Pavia, Italy; ³Controllo di Gestione Fondazione IRCCS Policlinico San Matteo di Pavia, Pavia, Italy; ⁴Dipartimento di Informatica e Sistemistica, Universita' degli Studi di Pavia, Pavia, Italy; ⁵Department of Information Systems and Computing, Brunel University, London, UK

Background and aims: The total health care cost for human immunodeficiency virus (HIV) patients has constantly grown in recent years. To date, there is no information about how this trend will behave over the next few years. The aim of the present study is to define a pharmacoeconomic model for the forecast of the costs of a group of chronically treated patients followed over the period 2004–2009.
Methods: A pharmacoeconomics model was built to describe the probability of transition among different health states and to modify the therapy over time. A Markov model was applied to evaluate the temporal evolution of the average cost. The health care resources exploited during hospitalization were analyzed by using an “activity-based costing” method.
Results: The Markov model showed that the mean total cost, after an initial increase, tended to remain stable. A total of 20 clinical records were examined. The average daily cost for each patient was EUR 484.42, with a cost for admission of EUR 6781.88.
Conclusion: The treatment of HIV infection in compliance with the guidelines is also effective from the payer perspective, as it allows a good health condition to be maintained and reduces the need and the costs of hospitalizations.

Keywords: health care cost, HIV, Markov model, activity-based costing