July 20, 2015

Expanding Access to HAART Saves Millions in Health Care and Productivity Costs

This post originally appeared on BC-CfE’s website here.

A study published in The Lancet HIV and presented at the 2015 International AIDS Society Conference by the BC Centre for Excellence in HIV/AIDS (BC-CfE) shows expanding Treatment as Prevention® (TasP®) could save up to $66.5 million over the next 25 years, compared with a scenario with reduced access to antiretroviral medication. The study finds expanded access to highly active antiretroviral therapy (HAART) has more than offset the additional costs of treatment, resulting in improved health outcomes and cost-savings.

Savings are due to reduced hospitalization costs, productivity gains and averted HIV infections through the implementation of TasP®. The expansion of TasP in British Columbia, with support from the provincial government, has resulted in decreased HIV morbidity and mortality, as well as a reduction in new HIV cases. BC is the only province in Canada to have implemented TasP and has had the greatest reductions in HIV incidence since combination antiretroviral therapy was introduced.

“These findings indicate Treatment as Prevention® could help to ensure greater sustainability of the Canadian health care system, if implemented on a national scale,” said Dr. Julio Montaner, Director of the BC-CfE. “At the global level, providing antiretroviral medication to those affected by HIV and AIDS could avert untold rates of illness, including in already resource-starved nations.”

The study estimated the decreases in injection risk behaviours observed in BC, due in large part to the expansion of harm reduction efforts, saved thousands of life-years and an estimated $42 million in medical care costs. Over the past 20 years, BC has rapidly expanded access to lifesaving opioid agonist therapy (with methadone or buprenorphine), implemented needle exchange programs and, in 2003, opened North America’s only supervised injection facility called Insite.

“TasP® produces the value for money when combined with harm reduction strategies,” said Dr. Bohdan Nosyk, Research Scientist with the BC-CfE, Associate Professor and St. Paul’s Hospital CANFAR Chair in HIV/AIDS Research at Simon Fraser University and lead author of the study. “Engaging individuals in HIV treatment and care provides measurable benefits to the health care system and society as a whole. Addressing the range of health needs of the populations most affected by HIV, such as drug use and addiction, helps to bolster health gains and cost-savings.”

By combining population-level surveillance, disease registry, and health administrative data, the study suggests expanded HIV testing and treatment in BC resulted in reduced HIV-related morbidity and mortality, and prevented up to 676 HIV infections from 1997-2010 (as compared to scenarios with reduced access to HAART).

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