부산대학교 도서관

Objective To evaluate the clinical and economical impact of the introduction of HIV protease inhibitor (PI) therapy in the current clinical care of HIV-infected patients. Methods Cohort study with 155 HIV-infected patients with a full year of follow-up before and after the introduction of PI by June 1998. The setting was a large urban tertiary teaching hospital in Madrid, Spain. The main outcomes measures were clinical and immunological evolution, pharmacy, out-patient, emergency room and in-patient medical costs evaluated by diagnostic-related group classification, and the global economic costs of clinical care in HIV-infected patients (AIDS and non-AIDS). Results The cost of PI therapy was compensated fully by savings related to reduction of the number, length and severity of hospital admissions in AIDS cases. In contrast, more modest clinical effects with increased costs were observed in non-AIDS cases. Globally, there was an increase of about 20% in the total health-care costs of HIV-infected patients (P < 0.01). Conclusions PI therapy is highly cost-effective in AIDS patients. Its value in less severely immunosuppressed patients requires further evaluation. [ABSTRACT FROM AUTHOR]