Expanding Access to HAART Saves Millions in Health Care and Productivity Costs

New BC-CfE research presented at IAS 2015 shows costs-savings to investment in HIV treatment


VANCOUVER, British Columbia, July 17, 2015 (GLOBE NEWSWIRE) -- A study published in The Lancet HIV by the BC Centre for Excellence in HIV/AIDS (BC-CfE) shows expanding Treatment as Prevention® (TasP®) could save up to $66.5 million over the next 25 years, compared with a scenario with reduced access to antiretroviral medication. The study finds expanded access to highly active antiretroviral therapy (HAART) has more than offset the additional costs of treatment, resulting in improved health outcomes and cost-savings.

Savings are due to reduced hospitalization costs, productivity gains and averted HIV infectio ns through the implementation of TasP®. The expansion of TasP® in British Columbia, with support from the provincial government, has resulted in decreased HIV morbidity and mortality, as well as a reduction in new HIV cases. BC is the only province in Canada to have implemented TasP® and has had the greatest reductions in HIV incidence since combination antiretroviral therapy was introduced.

"These findings indicate Treatment as Prevention® could help to ensure greater sustainability of the Canadian health care system, if implemented on a national scale," said Dr. Julio Montaner, Director of the BC-CfE. "At the global level, providing antiretroviral medication to those affected by HIV and AIDS could avert untold rates of illness, including in already resource-starved nations."

The study estimated the decreases in injection risk behaviours observed in BC, due in large part to the expansion of harm reduction efforts, saved thousands of life-years and an estimated $42 million in medical care costs. Over the past 20 years, BC has rapidly expanded access to lifesaving opioid agonist therapy (with methadone or buprenorphine), implemented needle exchange programs and, in 2003, opened North America's only supervised injection facility called Insite.

"TasP® produces the value for money when combined with harm reduction strategies," said Dr. Bohdan Nosyk, Research Scientist with the BC-CfE, Associate Professor and St. Paul's Hospital CANFAR Chair in HIV/AIDS Research at Simon Fraser University and lead author of the study. "Engaging individuals in HIV treatment and care provides measurable benefits to the health care system and society as a whole. Addressing the range of health needs of the populations most affected by HIV, such as drug use and addiction, helps to bolster health gains and cost-savings."

By combining population-level surveillance, disease registry, and health administrative data, the study suggests expanded HIV testing and treatment in BC resulted in reduced HIV-related morbidity and mortality, and prevented up to 676 HIV infections from 1997-2010 (as compared to scenarios with reduced access to HAART).

BACKGROUND

Treatment as Prevention® offers a path to end AIDS worldwide

In BC, with support from the provincial government, Treatment as Prevention® has resulted in a decrease of 65 per cent in new HIV cases, an 83 per cent drop in AIDS-related deaths, and an 88 per cent drop in new AIDS cases since 1994. International world leaders have endorsed the strategy including UN Secretary-General Ban Ki Moon, US President Bill Clinton, and US Secretary of State Hillary Clinton. The strategy has been adopted by China, France, Brazil, Spain, Panama, Argentina, Swaziland, the Australian state of Queensland, and parts of the United States – to name a few. TasP®, pioneered by Dr. Julio Montaner at the BC-CfE, forms the backbone of the UNAIDS 90-90-90 strategy to reach an AIDS-free generation by 2030.

Coupling TasP® with harm reduction strategies

Transmission of HIV among injection drug users has dramatically reduced through the implementation of Treatment as Prevention® (TasP®) and harm reduction strategies, including needle exchange programs and supervised injection facilities. BC-CfE researchers have created an extensive body of peer-reviewed research demonstrating the positive effects of harm reduction strategies on improving public health, reducing overdose deaths, increasing civil order and encouraging drug use cessation.

About the British Columbia Centre for Excellence in HIV/AIDS

The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada's largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul's Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. The BC-CfE's mission is to improve the health of British Columbians living with HIV through developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses.


            

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