The HIV Cost and Services Utilization Study

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Between 1994 and 2000, pharmaceutical and drug costs accounted for the majority of health care spending for HIV+ individuals

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SOURCE: Bozzette SA, Caring for HIV Patients: Good News and Bad News, RAND Corporation, 1999.

HCSUS is the first comprehensive U.S. survey of health care use among a nationally representative sample of persons in care for HIV. The study provided unique information on the costs of HIV care, barriers to access, and effects of HIV on quality of life, productivity, and family life. The study was conducted between 1994 and 2000. HCSUS has been cited by national policymakers as a key data source for the establishment of a federally funded HIV care benefiting low-income patients.

The study's overall results in 2000 found both good and bad news:

• The good news about HIV care in the United States was that treatment costs were not prohibitive--the average cost per patient equaled about $20,000 a year. Although these costs represented a growing burden on the public sector, they were still smaller than the costs of treating some other major diseases.
• The bad news, however, was that one-half to two-thirds of American adults infected with HIV were not getting regular care, and even fewer were receiving the most advanced type of care (antiretroviral therapy).
• The largest cost component was hospital care, but the costs of pharmaceuticals rose sharply during the course of the study period and were more than double the amount spent on outpatient care (see figure).

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