MANAGED CARE: HIV Care Costs Stabilized Between 1995 and 1997

      A trend analysis of HIV treatment costs recently found that average monthly costs of care for people with HIV in California and Texas managed care settings stabilized between 1995 and 1997 -- the same period protease inhibitors and triple cocktail therapy became widely prescribed. Diane Lapins, vice president of Strategic Services, Clinical Partners, Inc., a San Francisco-based company that provides data support and HIV case management services to managed care organizations, said, "Although the introduction of triple combination therapy led to a rise in patient-per-month drug costs from $200 to $1,100, this increase was accompanied by a corresponding decrease in average monthly non-drug costs from almost $1,300 to about $200, including hospital, professional, laboratory and home care services." The bottom line was a stabilized monthly per patient cost of about $1,400. Lapins said, "In fact, the overall average monthly cost of treating HIV patients held stable at about $1,300 over the last 14 months of this 36-month study." The analysis, conducted by Clinical Partners in collaboration with Merck & Co., Inc., also found that over the same two-year period, quarterly mortality rates dropped from almost 5% to less than 1%. The analysis studied HIV-positive non-Medicaid and non-Medi-Cal adults enrolled in various capitated, non-capitated and preferred provider health care plans managed by Clinical Partners in the two states. Lapins concluded, "As many managed care organizations tend to view drug budgets and drug costs independently of other operational costs, these data underscore the need for viewing the per patient cost of HIV care as a whole. It is important to recognize that HIV care encompasses many other components of care, such as indirect costs to community services, employers, friends and families." The study was presented Sunday at the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy (Merck release, 9/27).