Costi associati alle terapie antiretrovirali altamente efficaci (HAART): una previsione di spesa per la Regione Liguria

Background. The introduction of Highly active anti-retroviral therapy (Haart) in Hiv-infected individuals has been associated with a lower mortality rate and higher life expectancy. Nevertheless, the advent of Haart has led to an increase in the total care expenditure devoted to patients with Hiv infection, due to a significant rise in pharmaceutical expenditure (indeed the largest share of the total per-patient cost in Hiv treatment is now represented by Haart costs). Aims and method. This study is intended to investigate regional Haart expenditure, finding out its major determinants. Moreover, with the aim of evaluating Haart sustainability over the next 5-10 years, the study provides a forecast of the future evolution of regional Haart expenditure, assuming 3 different scenarios. Results. Focusing on treatment recommended under Italian national guidelines, results suggest that Haart cost containment could be obtained by the rational use of generic drugs, the use of new regimens with restrained prices and the price reduction of existing and recommended drugs. Conclusion. In order to reach medium term Haart economic sustainability, policy makers are required to pay attention to spending and cope with the cost containment goal. Otherwise, the risk incurred is that of reducing the use of innovative technologies and compromising Hiv-infected individuals’ health