Smit, M;
Cassidy, R;
Cozzi-Lepri, A;
Quiros-Roldan, E;
Girardi, E;
Mammone, A;
Antinori, A;
... Hallett, TB; + view all
(2017)
Projections of non-communicable disease and health care costs among HIV-positive persons in Italy and the USA: A modelling study.
PLoS ONE
, 12
(10)
, Article e0186638. 10.1371/journal.pone.0186638.
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Abstract
BACKGROUND: Country-specific forecasts of the growing non-communicable disease (NCD) burden in ageing HIV-positive patients will be key to guide future HIV policies. We provided the first national forecasts for Italy and the Unites States of America (USA) and quantified direct cost of caring for these increasingly complex patients. METHODS AND SETTING: We adapted an individual-based model of ageing HIV-positive patients to Italy and the USA, which followed patients on HIV-treatment as they aged and developed NCDs (chronic kidney disease, diabetes, dyslipidaemia, hypertension, non-AIDS malignancies, myocardial infarctions and strokes). The models were parameterised using data on 7,469 HIV-positive patients from the Italian Cohort Naïve to Antiretrovirals Foundation Study and 3,748 commercially-insured patients in the USA and extrapolated to national level using national surveillance data. RESULTS: The model predicted that mean age of HIV-positive patients will increase from 46 to 59 in Italy and from 49 to 58 in the USA in 2015–2035. The proportion of patients in Italy and the USA diagnosed with ≥1 NCD is estimated to increase from 64% and 71% in 2015 to 89% and 89% by 2035, respectively, driven by moderate cardiovascular disease (CVD) (hypertension and dyslipidaemia), diabetes and malignancies in both countries. NCD treatment costs as a proportion of total direct HIV costs will increase from 11% to 23% in Italy and from 40% to 56% in the USA in 2015–2035. CONCLUSIONS: HIV patient profile in Italy and the USA is shifting to older patients diagnosed with multiple co-morbidity. This will increase NCD treatment costs and require multi-disciplinary patient management.
| Type: | Article |
|---|---|
| Title: | Projections of non-communicable disease and health care costs among HIV-positive persons in Italy and the USA: A modelling study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1371/journal.pone.0186638 |
| Publisher version: | http://doi.org/10.1371/journal.pone.0186638 |
| Language: | English |
| Additional information: | © 2017 Smit et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
| Keywords: | Science & Technology, Multidisciplinary Sciences, Science & Technology - Other Topics, POPULATION, INFECTION, CASCADE |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10038816 |
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