Dr. John Shea, MD
April 2004
The failure, or perhaps the disinclination, of the Canadian media adequately to inform the public in regard to the cost of medical care for patients with HIV/AIDS was a subject of discussion in the editorial in the January 2004 issue of Catholic Insight. Here is provided a cursory review of the facts presently available.
Statistics
1) It is important to realize that “studies of HIV/AIDS costs often report costs that are three or four years old, do not reflect current needs or trends, and cannot be used on an ongoing basis.”
2) Ann Silversides reported in Extra magazine of Feb. 5, 2004, that Health Canada officials have no information on what AIDS patients died of, and caution that AIDS cases are under-reported, as are AIDS deaths, since it is not mandatory to report them. For example, if someone dies of liver disease as a result of AIDS, the person is listed as having succumbed to liver disease, not AIDS.
3) That said, Statistics Canada reported that in Canada in 2001, there were 50,259 persons who were HIV positive, and 18,018 who suffered from AIDS. That year also, Health Canada gave the number of new HIV infections per year as 3,000. The Canadian AIDS Society said it was 5,000 and that over half of them were under 25 years old. Extrapolating from these figures, one could estimate that the number of persons in Canada in 2003 who are HIV positive was between 56,000 and 60,000.
Employee benefits
4) Health Canada estimates that HIV infection costs employee benefit programs 100,000 dollars per employee per year. It also estimated that Canada lost eight billion dollars in 1995 in lost productivity and that the loss could be fifteen billion dollars by the year 2000. These figures agree with the estimates originally made by John McCallum, the Royal Bank’s chief economist, at the World AIDS Conference in Vancouver in 1996. At that time, McCallum predicted the cost of AIDS as thirty-eight billion dollars before 2011. (See my article: “Health and Homosexual Activity,” Catholic Insight, Sept., 1996, pp. 12-13)
Health costs
5) The Genuine Progress Index (GPI) for Atlantic Canada reported in 1999 that the overall cost of HIV/AIDS in Canada was over two billion dollars. Health care was 560 million, prevention research and support 40 million, and lost economic production due to premature death or disability, nearly 1.5 billion. They also reported that since 1990, the average age at death due to AIDS had increased from 36 to 41 years.
6) A research paper in 2003, based on data from southern Alberta, demonstrated that the cost of anti-viral drug treatment per patient per month had increased from $655 in 1995-96 to $1119 in 2000-01. Using these estimates of population numbers and costs, one could calculate that the cost of anti-viral drug therapy for HIV in Canada had risen to 806 million dollars per year by 2003.
7) The use of triple anti-retroviral drug therapy has increased the lifespan and quality of life and also decreased in-hospital treatment costs. However, overall costs are still rising in Canada because this optimal therapy with three anti-viral drugs is 3.5 times more expensive than dual therapy including generic AZT.
I stop here. As you can see, we are dealing with wildly varying estimates and uncertain reporting. The estimates vary from over $2 billion in 1999 (5) to $15 billion in 2000, depending on what is included (4). But if we have 60,000 HIV persons (3) and they cost $100,000 each per year (4), the total comes to $6 billion.
1. Hartmut B. Krentz et al, “The changing direct cost of medical care for patients with HIV/AIDS,” CMAJ, July 22, 2003; 169(2), pp.106-110.
2. John McCallum, Chief Economist, Royal Bank of Canada, The Globe and Mail, July 11, 1996.
3. 2004 GPI Atlantic, [email protected].
4. See reference 1.
5. Panita Pathipvanich et al, Journal of Acquired Immune Deficiency Syndromes, 02.01., 2003; Vol. 32:p.p. 157-60.
Dr. Shea can be reached via Catholic Insight at
[email protected]