EVALUATION OF DRUG-USE AND COST OF HOSPITAL-CARE FOR AIDS PATIENTS BETWEEN 1990 AND 1994

This study was designed to evaluate drug use and drug costs of treatme nt of 1112 AIDS patients at the Infectious Diseases Unit at F. Houphou et Boigny Hospital in Marseilles, France, between January 1, 1990 and December 31, 1994. All drug expenditures directly or indirectly relate d to AIDS treatment were recorded for both inpatients and outpatients. There were 1952 hospital stays. For each stay baseline characteristic s including age, sex, risk factors, costs, and duration of hospitaliza tion were noted. Patients were mainly young male drug addicts around t hirty years of age. Reason for admission was also noted. The overall n umber of admissions per year has decreased since 1991 probably due to development of outpatient care. The number of stays per patient per ye ar has decreased since 1993 because of the use of more appropriate the rapeutic and prophylactic protocols. The number of drugs used was high increasing from 750 in 1990 to 868 in 1994. Cost of treatment doubled between 1990 and 1994 due to the introduction of many expensive new d rugs. Closer analysis showed that the greatest increase in expenditure involved 'antibiotic/antiviral', 'psychiatry/neurology' and 'speciali zed therapy'. Although not frequently prescribed, costly drugs such as immunoglobulins, hematopoietic growth factors, and parenteral nutriti on solutions accounted for a high proportion of total costs. Since AZT , ddI and ddC were used mainly for outpatient treatment, their cost wa s low in inpatients. Cytomegalovirus-related retinitis, tuberculosis, and multiple infections were cost-intensive complications. The increas ing number of cytomegalovirus infections underline the need for cost e valuation and surveillance of this complication. This study demonstrat es that cost of treating drugs. This finding underlines the need to ev aluate and compare new therapeutic modalities in terms of cost effecti veness.