Options of potential socio-economic losses in according to different scenarios of drug provision and difference level coverage of antiretroviral therapy people living with HIV

Abstract

The aim - predict the epidemiological impact of HIV infection in Russia and assess the socio-economic losses to society depending on different scenarios of drug provision.

Material and methods. Simulations of differentiated outcomes of the disease and costs with different algorithms and coverage of HIV antiretroviral treatment for the population of Russia with an assessment of potential lost/saved years of life with their monetary expression in the five-years horizon (2019-2023).

Results and discussion. Continuous the current treatment algorithm with growth of spending on ARV therapy by 59.4% in the medium-term period (2018-2023) won't allow hold down HIV epidemic situation in Russia with 60 or 90% coverage: number of people living with HIV will increase by 12.1%, increase cases of death of HIV-infected - 35.4%. However, the expansion of treatment coverage to 90% of people living with HIV with a qualitative change in the treatment algorithm (ratio antiretrovirals first, second line and combined 40, 50, and 10%, with an efficiency of 81, 96, 96% respectively) and achievement of virological suppression in 90% of people living with HIV who received treatment, it will potentially allow to save 550.6 thousand years of life and 317.8 billion rubles in monetary terms in a five-year perspective.

Conclusion. Switching to 90% coverage with optimized treatment lines already in the medium term will provide a significantly more noticeable social impact than with keeping existing approaches. An additional increase in spending on new-generation antiretrovirals, offset by the increasing effectiveness of the annually used approach, will reduce the social economic burden on the Russian society in the context of HIV/AIDS epidemic.

Keywords:social-economic damage, HIV epidemic, coverage levels, antiretroviral therapy, drug provision for people living with HIV

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

For citation: Volkova O.I., Kurilovich E.O., Popovich L.D. Options of potential socio-economic losses in according to different scenarios of drug provision and difference level coverage of antiretroviral therapy people living with HIV. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2020; 9 (2): 8-17. DOI: 10.33029/2305-3496-2020-9-2-8-17 (in Russian)

References

1. Leonova O.H., Vinogradova T.N., Sizova N.V., Stepanova E.V. Problems of treating patients with severe HIV infections. VICH infektsiya i immu-nosupressii [HIV Infection and Immunosuppression]. 2013; 5 (2): 58-65. (in Russian)

2. Report No. 44, 2019. Rospotrebnadzor, Federal AIDS Center. (in Russian)

3. Report No. 43, 2018. Rospotrebnadzor, Federal AIDS Center. (in Russian)

4. Reference «HIV infection in the Russian Federation in 2019». Federal AIDS Center (in Russian)

5. Belyakov N.A., Ogurtsova S.V., Azovtseva O.V., Kurganova T.Yu., Mel’nikova T.N., Leonova O.N., et al. Analysis of the main epidemiological indicators of HIV infection and results of multi-year application of antiretroviral therapy (by the materials from the North-West of Russia). Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2020; 9 (1): 19-27. (in Russian)

6. Murray C.J.L., Lopez A.D. Measuring the global burden of disease. N Engl J Med. 2013; 369: 448-57.

7. Prokhorov B.B., Shmakov D.I. The costing of the statistical life and economic damage due to health problems. Problemy prognozirovaniya [Problems of Forecasting]. 2002; (3): 125-35. (in Russian)

8. Revich B.A., Avaliani S.L., Bobylev S.N., Safonov G.V., Sidorenko V. Methodical instructions. Economic assessment of public health losses due to adverse environmental factors. 2006. (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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