To study direct and indirect costs of AIDS and HIV infection for individuals, families, health services and societies and to eventually prepare a follow-up EC Concerted Action.
The study explored research in the economic aspects of acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection in the European Community at the end of the 1980s. The economic aspects looked at comprised the following:
the patterns of care and care processes;
cost issues (direct cost of medical care, cost of research and prevention, indirect cost);
cost effectiveness of prevention and treatment alternatives;
financing and insurance issues;
economic impact scenarios.
The study has identified a considerable number of European research approaches in the above listed fields. While the patterns of care and resource consumption linked therewith were a major focus of the studies, they were quite heterogeneous and often on a nonrepresentative basis. The group gathered however did not embark in a standardized collection of economic input information.
In contrast, a small group was formed to investigate scenarios on the economic impacts of HIV and AIDS. The dynamics of the spreading infectious disease make it necessary to link the economic work with up to date epidemiological modelling. This link is necessary to asses economic treatment impact, but also the epidemiological developments. There is little experience and large research needs in the integration of AIDS and HIV. The need for better integration between epidemiological and economic modelling is furthermore underlined by the effects of the use of new treatments technologies, since these interventions do have impacts both in economic and in epidemiological terms.
The aims were set in a situation where first US studies had identified that considerably high direct costs were incurred by AIDS and HIV infection, and that even higher indirect costs were caused by premature morbidity and mortality. These first studies varied with respect to patient groups and treatments observed, types of cost measured, and other methodological aspects. Clearly they seemed not to be directly transferable to the EC context. Beyond costs impacts of AIDS, other economic aspects - such as insurance issues - were also suspected. Against this background, the rather small exploratory study was defined with three lines of action:
- compilation and review of available publications, grey literature, information on ongoing or planned projects primarily in the European Community
- an international workshop on ongoing research studies, but also on ideas and project proposals
- eventually a draft for further EC Concerted Action.