Cost of medication therapy in ambulatory HIV-infected patients

OBJECTIVE: To examine the use and cost associated with prescribed medications as well as the use of over-the-counter medications and nontraditional therapies among ambulatory HIV-infected patients at Ryan White Title IIIb grantee centers. METHODS: Study participants (n = 223) were enrolled from eight centers across the US and Puerto Rico. Data were collected by a nurse, pharmacist, or physician through review of medical records and medication profiles. Information on the use of over-the-counter drugs and alternative therapies was obtained from the patients. RESULTS: Two hundred eleven (94.6%) patients received a mean +/- SD of 5.3 +/- 3.8 prescription medications during a consecutive 90-day period. The cost of medication was $1237.62 +/- $1751.49 per patient. Patients with a diagnosis of AIDS received a greater number of prescription drugs: an average of 6.6 compared with 3.4 among HIV-positive patients and 3.5 among asymptomatic patients. Antiretroviral agents were used by 143 (68.7%) patients. Zidovudine and stavudine had the highest cost ($611.81 +/- $254.10 and $596.96 +/- $352.80, respectively). Eighty-one (40.9%) patients reported the use of at least one over-the-counter product (range 0-11) and 11.8% reported use of alternative therapies. CONCLUSIONS: This study shows the cost of drug treatment for HIV-infected patients has remained stable since the early 1990s. However, it is anticipated this will change due to the introduction of new anti-HIV agents, greater use of combination therapies, greater use of prophylactic therapies, and increased survival times.