Antiretroviral Drugs Help HIV-infected Patients to Maintain Work Productivity

San Francisco—Employees with human immunodeficiency virus (HIV) incur considerably higher healthcare costs than non-HIV employees, but absenteeism costs do not drive the cost difference. Among the antiretroviral (ARV) drugs used to treat HIV, lopinavir/ritonavir (LPV/r) may provide a treatment option that conserves healthcare costs while permitting HIV employees to maintain work productivity.

The investigators presented the conclusions of a study, which was designed to assess healthcare costs and productivity in a cohort of employees receiving ARV treatment for HIV positive disease, during a poster session at the AMCP meeting. The poster was titled Employees Living with Human Immunodeficiency Virus: Impact of Disease and Antiretroviral Therapies on Healthcare Costs and Productivity.

Investigators retrospectively reviewed data from a database of employers’ payroll records and employee claims, looking at 2 cohorts of patients. One cohort was comprised of employees with HIV receiving treatment with ARV treatment with LPV/r (n=159), efavirenz (EFV) (n=275), or atazanavir with or without ritonavir (ATV±RTV) (n=74), and the other cohort was comprised of non-HIV employees (n=381,621).

Employees enrolled in the study were >18 years of age and had at least 3 months baseline data prior to the index date (assigned at the first prescription claim). The availability of other information, such as absence times and costs, sick leave, and short- and long-term disability, was needed on study participants eligible for selected analyses.

To assess healthcare costs and productivity, the investigators first characterized healthcare costs and productivity in the 2 cohorts. They then examined the healthcare costs by point of service (PoS) for patients treated with LPV/r, EFV, or ATV±RTV, as well as productivity losses for patients treated with 1 of the 3 ARV agents.

Compared with non-HIV employees, the study found that employees with HIV receiving ARVs had significantly higher monthly costs for medical healthcare ($241 vs $546, P<.0001), drugs ($41 vs $1183, P<.0001), total healthcare ($282 vs $1728, P<.0001), and short-term disability ($23 vs $55, P=.01).

In addition, HIV patients receiving ARVs had significantly more absence days for short-term disability per month than non-HIV employees (0.534 vs 0.142, P=.002); however, sick leave utilization was lower in the ARV-treated employees (0.187 days per month vs 0.257, P=.004).

When looking at healthcare costs by PoS, the employees receiving ARVs had significantly higher costs for all points of service except for the emergency department. Employees treated with LPV/r and EFV had similar costs in all service categories, whereas monthly total healthcare costs were significantly greater for employees treated with ATV±RTV compared with the LPV/r ($2322 vs $1799, P=.09) and EFV cohorts ($2322 vs $1674, P=.001).

The study also found that LPV/r- and EFV-treated patients had similar utilization of services, except for the number of ARV drug services that were significantly higher for LPV/r (1.68 vs 1.38, P=.001). The ATV±RTV-treated patients utilized significantly more drug services than EFV-treated patients (1.93 vs 1.38, P<.0001). Patients treated with ATV±RTV utilized significantly more non-ATV drugs compared with both LPV/r (2.33 vs 1.71, P=.01) and EFV (2.33 vs 1.54, P=.0006).

This study was supported by Abbott Laboratories, Inc.