Document 0251
 DOCN  M9460251
 TI    Zidovudine therapy and health resource utilization in AIDS.
 DT    9404
 AU    Moore RD; Hidalgo J; Bareta JC; Chaisson RE; Department of Medicine,
       Johns Hopkins University School of; Medicine, Baltimore, MD 21205.
 SO    J Acquir Immune Defic Syndr. 1994 Apr;7(4):349-54. Unique Identifier :
       AIDSLINE MED/94180308
 AB    We wished to determine whether antiretroviral therapy with zidovudine
       first received when a person is diagnosed with AIDS was associated with
       diminished or increased direct health resource utilization. As a measure
       of health resource utilization, we examined all Medicaid-administered
       health care charges to adult Maryland residents diagnosed with AIDS from
       1987 to 1989 who were part of the Human Immunodeficiency Virus
       Information System. We specifically compared those persons who first
       received zidovudine therapy either prior to or within 60 days of
       diagnosis of AIDS (n = 101) with those who never received zidovudine
       therapy (n = 279). Median survival time after diagnosis of AIDS in those
       who received zidovudine was 605 days and in those who did not receive
       zidovudine 235 days. After diagnosis of AIDS, median per-person lifetime
       direct health care charges to Medicaid were $66,200 in those who
       received zidovudine and $31,300 in those who did not receive zidovudine.
       The median incremental charge per year of life gained in zidovudine
       users was $34,600 compared with nonusers. Adjusting by proportional
       hazards regression for age, gender, race/ethnicity, HIV transmission
       risk group, AIDS-defining diagnosis, and length of follow-up, lifetime
       Medicaid charges were higher in zidovudine receivers. Compared with
       patients who did not receive zidovudine, patients who first received
       zidovudine at the time AIDS was diagnosed incurred higher cumulative
       lifetime charges, associated principally with longer survival time. The
       rate of resource utilization was not decreased by zidovudine use.
 DE    Acquired Immunodeficiency Syndrome/*DRUG THERAPY/*ECONOMICS/  MORTALITY
       Adult  Cost-Benefit Analysis  Female  Follow-Up Studies  Health Care
       Costs  Health Resources/ECONOMICS/*UTILIZATION  Human  Information
       Systems  Longitudinal Studies  Male  Maryland  Medicaid/ECONOMICS
       Middle Age  Probability  Proportional Hazards Models  Support, Non-U.S.
       Gov't  Support, U.S. Gov't, Non-P.H.S.  Survival Analysis  Time Factors
       United States  Zidovudine/*THERAPEUTIC USE  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).