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目的:估算我国综合性艾滋病研究项目(China integrated program for research on AIDS,China,CIPRA)临床治疗的直接成本,为在我国农村地区推行艾滋病(HIV/AIDS)高效抗逆转录病毒治疗(Highly Active Anti-retroviral therapy,HAART)提供卫生经济学方面的参考依据。方法:收集治疗的成本资料,根据当地的医疗服务价格水平,估算包括抗病毒药品费用、随访检查费用及不良事件(adverse event,AE)处理费用的直接成本。结果:治疗1年期间,100例患者因不良事件平均每人住院为3.5天,每人门诊治疗为3.6次,平均每日住院费用和每次门诊费用分别为186.8元和43.0元。每人治疗总费用为26521.3元,其中抗病毒药品费用占67.0%,有效性监测费用占26.4%,安全性监测费用占3.5%,不良事件处理费用占3.0%,处理不良事件的费用约占当地农民人年均收入的30.0%。结论:按本方案在中国中西部农村地区以县级医疗机构为基点开展HAART治疗,每人每年的直接成本约为26500.0元,安全性监测费用占总费用比例较小,是为保证HAART治疗安全必须优先投入的部分。不良事件处理费用成为当地HIV/AIDS患者的重要经济负担,需要相应的补偿机制予以分担。
OBJECTIVE: To estimate the direct cost of clinical treatment of China’s integrated program for research on AIDS (China, CIPRA) in order to promote Highly Active Anti-HIV in HIV / AIDS patients in rural areas of China. -retroviral therapy, HAART) provides a reference for health economics. METHODS: The costs of treatment were collected and the direct cost of handling antivirus drugs, follow-up checks and adverse events (AE) was estimated based on local medical service price levels. Results: During the one-year treatment period, 100 patients were hospitalized for 3.5 days on average because of adverse events and 3.6 times per patient for out-patient treatment. The average daily hospitalization expenses and outpatient visits were 186.8 yuan and 43.0 yuan respectively. The total cost of treatment per person was 26521.3 yuan, of which 67.0% of antiviral drugs cost effectiveness monitoring costs accounted for 26.4%, safety monitoring costs accounted for 3.5%, adverse event handling costs accounted for 3.0%, the cost of handling adverse events accounted for about 30.0% of average annual income of farmers. Conclusion: According to this project, HAART treatment is carried out in rural areas of central and western China based on county-level medical institutions. The direct cost per person per year is about 26,500.0 yuan. The proportion of safety monitoring expenses in total costs is small, so as to ensure the safety of HAART treatment Must be given priority to the part. Adverse event handling costs have become an important financial burden on local HIV / AIDS patients and need to be shared by appropriate compensation mechanisms.