A study analyzing two decades of data from the US Department of Veterans Affairs (VA) examined the significant health care burden associated with HIV drug resistance. The research found that veterans with resistance-associated mutations (RAMs) to antiretroviral therapy (ART) experienced greater health care resource utilization (HCRU) and incurred higher overall medical costs.

The study included data from 7746 veterans with HIV who underwent resistance testing at VA health centers between 2003 and 2023. Among them, 5871 had at least one RAM detected. While baseline demographics and comorbidities were similar between groups, those with ART resistance had significantly higher rates of hospitalization (26.1% vs 21.3%; P < .001) and outpatient visits.

Total health care costs were greater in the resistance cohort, averaging $49 945 ± $69 861 per member per year compared to $45 476 ± $57 117 in the nonresistance group, though this difference was not statistically significant (P = .037). Notably, HIV-specific pharmacy costs were lower in the resistance group ($14 298 ± 10 470 vs $13 701 ± 11 490; P = .045), suggesting that increased spending was driven primarily by inpatient and outpatient services.

The findings underscore the clinical and economic impact of ART resistance in the aging HIV-positive population. As resistance can compromise treatment effectiveness, the study reinforces the need for vigilant monitoring, timely resistance testing, and novel therapeutic strategies to reduce hospitalizations and improve outcomes.

Reference

Sutton S, Magagnoli J, Cummings T, et al. Health care resource use outcomes associated with antiretroviral resistance among US veterans with HIV. Presented at: AMCP 2025; March 31-April 3; Houston, TX; Abstract B7.