Costs estimates for HIV care and patient characteristics for health resource utilisation from linkage of claims data with the Swiss HIV Cohort Study. Clinical Infectious Diseases
Leon-Reyes et al. aimed to study the costs for HIV-related and non-HIV-related conditions and their main determinants by matching Swiss HIV Cohort Study (SHCS) and claims data from the largest Swiss health insurer.
All policyholders from the health insurance Helsana with an antiretroviral therapy (ART) record (n = 2355) and patients from the SHCS receiving ART (n = 9326) during 2012 and or 2013 were considered for anonymous data linkage. The primary end points were total healthcare costs per year per patient in the HIV-infected population of Switzerland. Patients were classified into low, moderate, high, and unclassified risk groups for resource use.
The corrected mean (standard error) total costs in 2012 and 2013 were
$ 30’462 ($ 582) and $ 30’965 ($ 629) and mainly accrued in ambulatory care for ART (70% of mean costs).
The low-risk group for resource use had mean (standard error) annual costs of
$ 26’772 ($ 536) and $ 26’132 ($ 589) in 2012 and 2013.
In the moderate- and high-risk groups, annual costs for 2012 and 2013 were higher by
$ 3’526 (95% confidence interval, $ 1’907 – $ 5’144) (13%) and $ 4’327 ($ 2’662 – $ 5’992) (17%) and
$ 14’026 ($ 8’763 – $ 19’289) (52%) and $ 13’567 ($ 8’844 – $ 18’288) (52%), respectively.
In conclusion, in this representative subsample of SHCS patient from a pilot linkage study with claims data, ART was the major cost factor. Patient profiling allowed identification of multiple factors related to higher resource use, including age, previous AIDS, psychiatric comorbid conditions, illicit drug and alcohol use, and lower adherence to ART. Repeated matching of SHCS and claims data in a larger sample could provide essential data to model important future costs that will inform health policy making on different levels.