Trends in Costs for HIV Care During a Hepatitis C Virus Early Treatment and Elimination Program: A Data Linkage Study of Claims and Swiss HIV Cohort Study Data - Scorecard - MDSpire

Trends in Costs for HIV Care During a Hepatitis C Virus Early Treatment and Elimination Program: A Data Linkage Study of Claims and Swiss HIV Cohort Study Data

  • By

  • Soheila Aghlmandi

  • Kurt Schmidlin

  • Carola Huber

  • Pascal Godet

  • Katharina Kusejko

  • Marcel Stoeckle

  • Matthias Cavassini

  • Huldrych F Günthard

  • Enos Bernasconi

  • Alexandra Calmy

  • Patrick Schmid

  • Cornelia Staehelin

  • Niklaus D Labhardt

  • Heiner C Bucher

  • Swiss HIV Cohort Study

  • I Abela

  • K Aebi-Popp

  • A Anagnostopoulos

  • M Battegay

  • E Bernasconi

  • D L Braun

  • H C Bucher

  • A Calmy

  • M Cavassini

  • A Ciuffi

  • G Dollenmaier

  • M Egger

  • L Elzi

  • J Fehr

  • J Fellay

  • H Furrer

  • C A Fux

  • H F Günthard

  • A Hachfeld

  • D Haerry

  • B Hasse

  • H H Hirsch

  • M Hoffmann

  • I Hösli

  • M Huber

  • C R Kahlert

  • L Kaiser

  • O Keiser

  • T Klimkait

  • R D Kouyos

  • H Kovari

  • K Kusejko

  • G Martinetti

  • B Martinez de Tejada

  • C Marzolini

  • K J Metzner

  • N Müller

  • J Nemeth

  • D Nicca

  • P Paioni

  • G Pantaleo

  • M Perreau

  • A Rauch

  • P Schmid

  • R Speck

  • M Stöckle

  • P Tarr

  • A Trkola

  • G Wandeler

  • S Yerly

  • July 16, 2025

  • 0 min

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Clinical Scorecard: Analysis of Healthcare Expenditures for HIV Management Amid Early Hepatitis C Virus Treatment and Elimination Initiatives: A Study Utilizing Swiss HIV Cohort and Claims Data Integration

At a Glance

CategoryDetail
ConditionHIV infection with or without chronic hepatitis C virus (HCV) coinfection
Key MechanismsAntiretroviral therapy (ART) for HIV; direct-acting agents (DAAs) for chronic HCV treatment
Target PopulationPeople with HIV (PWH) in Switzerland, including those coinfected with HCV
Care SettingSwiss healthcare system with universal mandatory health insurance covering outpatient and inpatient care

Key Highlights

  • Mean adjusted annual overall healthcare costs for PWH in Switzerland were stable from 2012 to 2017, increasing slightly from CHF 24,713 to CHF 24,881.
  • ART costs were the largest contributor to overall costs but decreased over time, while hospitalization costs increased by 7.2% annually.
  • Introduction of DAAs for HCV treatment in coinfected PWH led to a significant but marginal increase in overall costs, with mean additional costs of CHF 52,647 per treated patient.

Guideline-Based Recommendations

Diagnosis

  • Regular monitoring of HIV viral load and CD4 cell counts as per Swiss HIV Cohort Study protocols.
  • Screening for HCV coinfection in PWH to identify candidates for DAA therapy.

Management

  • Initiation and continuation of ART for all PWH to control HIV infection.
  • Use of direct-acting agents (DAAs) for effective treatment and elimination of chronic HCV in coinfected patients.
  • Management of comorbidities including psychiatric, cardiovascular, metabolic, and liver-related conditions.

Monitoring & Follow-up

  • Biannual clinical visits for PWH as per SHCS standards.
  • Monitoring for hospitalizations and comorbidity development to optimize care and resource use.

Risks

  • Potential increased hospitalization costs despite stable ART costs.
  • Financial impact of high-cost DAA therapies on healthcare budgets, though contribution to overall costs remains marginal.

Patient & Prescribing Data

1830 PWH linked from the Swiss HIV Cohort Study with claims data from 2012 to 2017, including 171 (9.4%) coinfected with HCV treated with DAAs.

ART remains the primary cost driver but shows decreasing costs over time; DAA treatment for HCV coinfection is associated with a substantial one-time cost increase but contributes marginally to total healthcare expenditures.

Clinical Best Practices

  • Utilize privacy-preserving probabilistic record linkage to integrate cohort and claims data for comprehensive cost and care analyses.
  • Maintain universal access to ART and incorporate HCV elimination programs using DAAs for coinfected patients.
  • Monitor trends in hospitalization and comorbidity-related costs to inform resource allocation and healthcare planning.

References

Original Source(s)

Trends in Costs for HIV Care During a Hepatitis C Virus Early Treatment and Elimination Program: A Data Linkage Study of Claims and Swiss HIV Cohort Study Data

  • by Soheila Aghlmandi, Kurt Schmidlin, Carola Huber, Pascal Godet, Katharina Kusejko, Marcel Stoeckle, Matthias Cavassini, Huldrych F Günthard, Enos Bernasconi, Alexandra Calmy, Patrick Schmid, Cornelia Staehelin, Niklaus D Labhardt, Heiner C Bucher, Swiss HIV Cohort Study, I Abela, K Aebi-Popp, A Anagnostopoulos, M Battegay, E Bernasconi, D L Braun, H C Bucher, A Calmy, M Cavassini, A Ciuffi, G Dollenmaier, M Egger, L Elzi, J Fehr, J Fellay, H Furrer, C A Fux, H F Günthard, A Hachfeld, D Haerry, B Hasse, H H Hirsch, M Hoffmann, I Hösli, M Huber, C R Kahlert, L Kaiser, O Keiser, T Klimkait, R D Kouyos, H Kovari, K Kusejko, G Martinetti, B Martinez de Tejada, C Marzolini, K J Metzner, N Müller, J Nemeth, D Nicca, P Paioni, G Pantaleo, M Perreau, A Rauch, P Schmid, R Speck, M Stöckle, P Tarr, A Trkola, G Wandeler, S Yerly

  • July 16, 2025

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