Costing of scaling up HIV/AIDS treatment in Mexico [Costos del tratamiento de VIH/SIDA en México]

Objective. To determine the net effect of introducing highly active antiretroviral treatment (HAART) in Mexico  on  total  annual  per-patient costs for HIV/AIDS care, taking into account potential savings from treatment of opportunistic infections and hospitalizations. Material and Methods. A multi-center, retrospective patient chart review and collection of unit cost data were performed to describe the utilization of services and estimate costs of care for 1 003 adult HIV+ patients in the public sector. Results. HAART is not costsaving and the average annual cost per patient increases after initiation of HAART due to antiretrovirals, accounting for 90% of total costs. Hospitalizations do decrease post-HAART, but not enough to offset the increased cost. Conclusions. Scaling up access to HAART is feasible in middle income settings. Since antiretrovirals are so costly, optimizing efficiency in procurement and prescribing is paramount. The observed adherence was low, suggesting that a proportion of these high drug costs translated into limited health benefits.