SURVIVAL AND THE USE AND COSTS OF HOSPITAL SERVICES FOR LONDON AIDS PATIENTS TREATED WITH AZT

The aim of this study was to evaluate the survival patterns and use an d cost of hospital services of AIDS patients treated with azidothymidi ne (AZT) at St Mary's Hospital, London. A retrospective analysis of in patient and outpatient case notes was performed, as was a survey of HI V-related care costs in 37 clinical departments. Of the 183 AIDS patie nts managed between 1 January 1987 and 30 September 1989, 132 were tre ated with AZT and 51 without AZT. Mean age at time of AIDS diagnosis f or these predominantly homosexual men was 37.5 years for those treated with AZT compared with 40.7 years for those not on AZT. Median surviv al time from date of AIDS diagnosis was significantly longer for patie nts treated with AZT compared with those not treated with AZT (23 vs 1 3.5 months, P=0.0004). The interval from diagnosis of HIV infection to date of AIDs diagnosis did not differ significantly between groups. I npatient and outpatient use of services was greater for those receivin g AZT than for those who did not. Costs reflected this increased use o f services and the costs for those treated with AZT were pound 3061 pe r AIDS patient-year higher compared with AIDS patients not receiving A ZT; 36% of this cost was directly attributable to the cost of AZT itse lf. The introduction of AZT into routine clinical practice seems to ha ve been a cost-effective intervention though it has been associated wi th an increased use of hospital services and associated costs per AIDS patient-year as well as increased survival time from AIDS diagnosis.