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Clinical and Economic Implications of Non-Adherence to HAART in HIV Infection

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Author Info

  • Alissa Scalera

    (Department of Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada)

  • Ahmed M. Bayoumi

    (Ontario HIV Treatment Network, Toronto, Ontario, Canada)

  • Paul Oh

    (HOPE Research Centre, Sunnybrook and Women's College Health Science Center, Toronto, Ontario, Canada)

  • Nancy Risebrough

    (HOPE Research Centre, Sunnybrook and Women's College Health Science Center, Toronto, Ontario, Canada)

  • Neil Shear

    (Department of Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada)

  • Alice Lin-in Tseng

    (Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada)

Registered author(s):

    Abstract

    Highly active antiretroviral therapy (HAART) has dramatically altered the natural history of HIV disease. Studies demonstrate that >=95% adherence is necessary to garner the full benefits of HAART. However, appropriate adherence to treatment is difficult and challenging. This paper provides an overview of potential clinical and economic outcomes associated with poor adherence to HAART. Since there are no studies exploring the costs associated with poor adherence to HAART, we discuss potential direct and indirect costs accrued with more frequent treatment failures, selection of resistant strains, increased hospitalizations and a faster progression to AIDS associated with poor adherence to HAART. Additionally, we review studies of interventions and strategies to improve adherence to HAART. Although, single-focus interventions have enhanced the chances of achieving viral suppression by 10 to 23%, the literature has demonstrated that for long-term treatments, programs employing diverse interventions that continue over time are more effective. Under constrained healthcare budgets, government, healthcare managers and policy makers require accurate and timely information concerning the cost effectiveness of adherence intervention programs. We discuss considerations in determining the cost effectiveness of an adherence intervention program.

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    Bibliographic Info

    Article provided by Wolters Kluwer Health | Adis in its journal Disease Management & Health Outcomes.

    Volume (Year): 10 (2002)
    Issue (Month): 2 ()
    Pages: 85-91
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:dmhout:v:10:y:2002:i:2:p:85-91

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    Web page: http://diseasemanagement.adisonline.com/

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    Related research

    Keywords: Antiretrovirals; Cost analysis; HIV infections; Patient compliance; Pharmacoeconomics;

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