UPDATES OF COST OF ILLNESS AND QUALITY-OF-LIFE ESTIMATES FOR USE IN ECONOMIC EVALUATIONS OF HIV PREVENTION PROGRAMS

To allocate limited economic and other resources for HIV prevention an d treatment for maximum benefit? health policy planners and decision m akers require accurate, current estimates of the lifetime costs of HIV -related illness and the impact of therapy on the quality of life of H IV-infected persons. These data are central input parameters to the ec onomic evaluation methodology known as cost-utility analysis. The esti mates available in the literature are already outdated, and this paper presents updated estimates of the projected lifetime health care cost s associated with HIV disease in the United States and the number of q uality-adjusted life years (QALYs) lost to HN in light of recent advan cements in HIV diagnostics and therapeutics. Results indicate that the lifetime cost of HIV medical care has grown from about $55,000 U.S. t o more than $155,000 U.S., while the number of QALYs lost per case of HIV infection has decreased from 9.26 to 7.10, when discounted at a 5% annual rate. When these figures are discounted instead at the newly r ecommended 3% rate, lifetime costs rise to more than $195,000 U.S. and lost QALYs increase to 11.23. The net effect of these increases in th e medical costs of care and treatment saved by averting an HIV infecti on and in QALYs makes HN prevention a relatively more cost-effective s trategy than other, non-HIV health-related programs.