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Comorbidities and HCV coinfection in the management of HIV+ patients: evidence from the Italian clinical practice

Author

Listed:
  • Elisabetta Garagiola

    (Centre for Research on Health Economics, Social and Health Care Management, LIUC–Università Cattaneo)

  • Emanuela Foglia

    (Centre for Research on Health Economics, Social and Health Care Management, LIUC–Università Cattaneo)

  • Lucrezia Ferrario

    (Centre for Research on Health Economics, Social and Health Care Management, LIUC–Università Cattaneo)

  • Paola Meraviglia

    (Fatebenefratelli Sacco Hospital)

  • Alessandro Tebini

    (Valle Olona Hospital)

  • Barbara Menzaghi

    (Valle Olona Hospital)

  • Chiara Atzori

    (Fatebenefratelli Sacco Hospital)

  • Giuliano Rizzardini

    (Fatebenefratelli Sacco Hospital
    University of the Witwatersrand)

  • Teresa Bini

    (Santi Paolo e Carlo Hospital)

  • Antonella D’Arminio Monforte

    (Santi Paolo e Carlo Hospital)

  • Davide Croce

    (Centre for Research on Health Economics, Social and Health Care Management, LIUC–Università Cattaneo
    University of the Witwatersrand)

Abstract

Background Since HIV+ treatment has become more effective, the average age of people living with HIV (PLWHIV) has increased, and consequently the incidence of developing comorbidities, making the clinical and economic management of HIV+ patients more complex. Limited literature exists regarding the management of comorbidities costs. This study is aimed at defining and comparing the total annual costs of comorbidities, in an Italian cohort of HIV and HIV/HCV patients, from the National Healthcare Service perspective. The authors hypothesised that there are higher costs, for patients with multiple comorbidities, and a greater consumption of resources for HIV/HCV co-infected patients versus HIV mono-infected patients. Methods An observational retrospective multi-centre health-economics study, enrolling HIV+ and HIV/HCV consecutive patients with at least one comorbidity, was conducted. The consecutive cases, provided by three Italian infectious diseases centres, were related to the year 2016. The enrolled patients were on a stable antiviral therapy for at least six months. Demographic and clinical information was recorded. Costs related to HIV and HCV therapies, other treatments, medical examinations, hospitalizations and outpatient visits were evaluated. Data from mono-infected and co-infected groups of patients were compared, and the statistical analysis was performed by t-tests, chi-square and ANOVA. A sub-analysis excluding HCV therapy costs, was also conducted. The hierarchical sequential linear regression model was used to explore the determinants of costs, considering the investigated comorbidities. All analyses were conducted with a significant level of 0.05. Results A total of 676 patients, 82% male, mean age 52, were identified and divided into groups (338 mono-infected HIV+ and 338 co-infected HIV/HCV patients), comparable in terms of age, gender, and demographic characteristics. A trend towards higher annual costs, for patients with multiple comorbidities was observed in HIV mono-infected patients (respectively € 8272.18 for patients without comorbidities and € 12,532.49 for patients with three or more comorbidities, p-value: 0.001). Excluding anti-HCV therapies costs, HIV/HCV co-infected patients generally required more resources, with statistically significant differences related to cardiovascular events (€10,116.58 vs €11,004.28, p-value: 0.001), and neurocognitive impairments events (€7706.43 vs €11,641.29 p- value:

Suggested Citation

  • Elisabetta Garagiola & Emanuela Foglia & Lucrezia Ferrario & Paola Meraviglia & Alessandro Tebini & Barbara Menzaghi & Chiara Atzori & Giuliano Rizzardini & Teresa Bini & Antonella D’Arminio Monforte , 2020. "Comorbidities and HCV coinfection in the management of HIV+ patients: evidence from the Italian clinical practice," Health Economics Review, Springer, vol. 10(1), pages 1-11, December.
  • Handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00284-x
    DOI: 10.1186/s13561-020-00284-x
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    References listed on IDEAS

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    1. Francesco Saverio Mennini & Andrea Marcellusi & Massimo Andreoni & Antonio Gasbarrini & Salvatore Salomone & Antonio Craxì, 2014. "Health Policy Model: Long-term Predictive Results Associated With The Management Of HCV-Induced Diseases In Italy," CEIS Research Paper 308, Tor Vergata University, CEIS, revised 17 Feb 2014.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Angela Devine’s journal round-up for 28th September 2020
      by Angela Devine in The Academic Health Economists' Blog on 2020-09-28 11:00:07

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