Direct costs of health care for HIV/AIDS patients in Belgium

The cost of HIV/AIDS care was measured in Belgium in 1996. This paper is co ncerned with direct costs (formal and informal care). This is a prospective study, stratified by CDC-disease stage. A societal point of view was chose n. Eighty-two sequential patients agreed to join the study during outpatien t visits. Data on service use and costs were obtained through a care-cost d iary kept over three months. Half of the patients (41) returned a completed diary, which reduced the sample size considerably. Additional billing data were obtained from different sources and by calculating the time spent for certain services. In stage A (asymptomatic HIV), the mean ( +/-SD) annual total direct costs are US$2,373 (2,079), rising to US$8,401 (7,520) in stag e B (symptomatic HIV) and ending up at US$27,373 (22,087) in stage C (full blown AIDS). A difference in balance of costs at different stages of diseas e was observed. The principal cost of outpatient pharmaca in HIV patients i s overtaken by the cost of hospitalization in AIDS patients. The cost of in formal care is considerable (40% of the total cost) from stage B onwards. H ealth care use and costs increase with severity of illness.