A Study on the Medical Care Cost for People with HIV/AIDS in Japan

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  • ICHIKAWA Seiichi
    Laboratory of Public Health, Kanagawa Prefectural College of Nursing and Medical Technology
  • KIMURA Satoshi
    Department of Infection Control and Prevention, Department of Infectious Diseases, Graduate School of Medicine, the University of Tokyo
  • OHYA Hitomi
    Laboratory of Public Health, Kanagawa Prefectural College of Nursing and Medical Technology
  • KIMURA Hirokazu
    Department of Public Health, School of Medicine Yokohama City University
  • OKA Shin-ichi
    International Medical Center of Japan
  • ITOH Akira
    Yokohama City University Hospital
  • MASUDA Gohta
    Tokyo Metropolitan Komagome Hospital
  • HANABUSA Shuji
    Ogikubo Hospital
  • SAGARA Hiroko
    Yokohama Municipal Hospital
  • HASHIMOTO Shuji
    School of Health Sciences and Nursing, the University of Tokyo
  • KAMAKURA Mitsuhiro
    Department of Preventive Medicine and Public Health, Clinic for Infectious Diseases, School of Medicine, Keio University
  • NAKAMURA Yosikazu
    Department of Public Health, Jichi Medical School
  • KIHARA Masahiro
    Department of Epidemiology, Kanagawa Cancer Center Research Institute

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Other Title
  • ＨＩＶ／ＡＩＤＳ医療費に関する研究　ＡＺＴ，ｄｄＩの占める費用割合
  • HIV AIDS イリョウヒ ニ カンスル ケンキュウ AZT ddI ノ シメル ヒヨウ ワリアイ
  • AZT, ddIの占める費用割合

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Objective: In this study, we categorized patients with HIV (PWH) and AIDS (PWA) according to the CD4 cell count, and separately analyzed the costs of outpatient and inpatient care for the hemophiliac and non-hemophiliac patients in each category.<BR>Materials & Methods: HIV infection was classified into 4 stages reflecting severity of disease. The stages were AC-1 (n=28), CD4 cell count ≥500; AC-2 (n=45), CD4 count 200-500; AC-3 (n=34), CD4 count less than 200; and AIDS patients (n=46). The costs of outpatient and inpatient care for PWH and PWA were investigated on the basis of receipts for monthly statements of insurance payments. The costs of medication were calculated item by item for each patient, and the mean cost of medical care per day was calculated for the 4 disease stage groups by dividing the costs by the actual number of days of outpatient or inpatient care. In the patients receiving anti-HIV drugs, we calculated the costs of AZT and ddI, and determined the percentage of the total cost of medical care occupied by anti-HIV drugs.<BR>Results: The monthly cost of medical care for the non-hemophiliac patients receiving anti-HIV drugs was 2.5 times and 3.5 times higher in the AC-2 and AC-3 groups, respectively, than that in the AC-1 group of patients not receiving anti-HIV drugs. The cost of anti-HIV drugs accounted for more than 60% of the total cost. A similar tendency was also observed in the hemophiliac patients, and anti-HIV drugs accounted for 40-60% of the cos of medical care excluding the home-care costs of coagulation factor products . The life-time cost for HIV/AIDS treatment with anti-HIV drugs was estimated to be 13, 440, 000 yen.<BR>Conclusion: The cost of outpatient care increased as the disease progressed; especially, in terms of the use of anti-HIV drugs.

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