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Cost of Comorbidities/HIV: Mean costs of care increased from $30,312 for those without an identified comorbidity to over $46,000 for those with 2 comorbidities, and up to $219,000 for people with 11 or more.
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The cost of comorbidities in treatment for HIV/AIDS in California
December 14, 2017
The findings of this paper describe how medical complexity dramatically increases the already high baseline costs of care for PLWH. In our sample of Medicare enrollees with HIV, nearly 2/3 (64%) had at least one non-HIV related condition, and 39% had two or more. Mean costs of care increased from $30,312 for those without an identified comorbidity to over $46,000 for those with 2 comorbidities, and up to $219,000 for people with 11 or more. Our data confirm that the greater prevalence of comorbidities with increasing age of HIV-infected patients primarily accounts for increased inpatient and outpatient costs with age.[10]
Multimorbidity is also common among PLWH. Insurance claims data show that among PLWH aged 50 and older, 22% had one medical condition in addition to HIV, 36% had 2–3 comorbidities, 15% had 4–5, and 10% had >5.[13] There is also evidence that PLWH may develop some diseases at earlier ages than people who are not infected with HIV due to immune exhaustion from chronic inflammation engendered by even well-controlled/treated HIV infection.[16]. A study in Italy estimated that PLWH experience rates of non-infectious comorbidities that were comparable to those of patients without HIV who were 10–15 years older. [11]
Dual enrollees, with both Medicare and Medicaid coverage, had median outpatient costs that were 21% greater than Medicare-Only patients.
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