The clinical and economic efficacy of HAART: a shift from inpatient medical to outpatient pharmaceutical care for HIV/AIDS patients in Northeastern Italy.

Abstract This study describes epidemiological, clinical and economic impact of the HIVepidemic in Italy prior to and after the introduction of HAART. A prospective, observational, multi-center design was applied using data collected on an AIDS cohort from 1994 and updated data from a comparable cohort in 1998. Mortality and direct medical costs were measured in 251 AIDS patients in 1994 and 77 AIDS patients in 1998. A considerable difference was observed in mortality (33.9% in 1994 vs. 3.9% in 1998). The numbers of hospital admissions were 1.9 in 1994 and 0.8 in 1998; average length of stay was 31.4 days in 1994 and 12.6 days in 1998. The cost per patient per year was 17,250 Euros in 1994 and 11,465 Euros in 1998. The comparison of two cohorts between time periods has enabled changes in costs and outcomes to be linked to the introduction of HAART in 1997. In conclusion, after the introduction of HAART hospital-based provision shifted from an inpatientbased to an outpatient-based service with major focus on pharmaceutical care.