HIV therapy and prevention: economics and cost-effectiveness.

Highly active antiretroviral therapy (HAART) is proving to be effective and cost-effective in the developed world. One study shows HAART contributed to a 37 percent decrease in hospital admissions and a 41 percent decrease in hospital days. Other studies indicate that HAART regimens have a cost- effectiveness well within the range of currently funded and reimbursed therapies for other opportunistic diseases as well. Cost-effectiveness studies of preventive programs revealed a multiplier effect, where the prevention of primary infections also resulted in the prevention of secondary and tertiary infections. CDC estimated that counseling and testing could save $700,000 per 10,000 individuals. Unfortunately, several of the studies are showing that developing countries are having difficulties in gaining access to anti-HIV drugs, and the higher pharmaceutical costs are not often being offset by a decrease in inpatient costs. The use of these therapies in developing countries is much less cost-effective.