Early Treatment for HIV Act Could Reduce Death Rate of HIV-Positive People on Medicaid by 50%, Study Shows
The Treatment Access Expansion Project, a collaborative project of the HIV/AIDS community, health care providers and the pharmaceutical industry, last week released the results of a study conducted by PriceWaterhouseCoopers on the health, economic and public health benefits of providing early access to HIV treatment as outlined under the proposed Early Treatment for HIV Act (SB 847), according to a TAEP release (TAEP release, 7/2). ETHA, which was introduced in the Senate in April by Sens. Gordon Smith (R-Ore.) and Hillary Rodham Clinton (D-N.Y.), would provide Medicaid coverage for HIV-positive, low-income people before they develop AIDS. The bill also would provide additional Medicaid funds to states that invest in HIV treatment, and the legislation would allow states with budget deficits to continue to provide medical treatment to HIV-positive, low-income individuals (Kaiser Daily HIV/AIDS Report, 4/11). Under current Medicaid rules, HIV-positive people must wait until they can be categorized as "disabled" before receiving treatment through the program. For the study, PwC developed an HIV cost model and used traditional budget analysis and "true cost" analysis to assess the costs and benefits of the proposed changes under ETHA (TAEP release, 7/2). Based on estimates of low-income populations currently ineligible for Medicaid, the study assumes that 30,000 people would enroll in ETHA if all states participated in the program (Rodgers/Yip, "An Analysis of The Early Treatment for HIV Act," 5/27).
The study found that over 10 years, ETHA could reduce by 50% the death rate for HIV-positive people on Medicaid. In addition, over 10 years, disease progression could be slowed and health outcomes improved, meaning that 35,000 more HIV-positive people than under baseline Medicaid care would have CD4+ T cell levels under 500. PwC found that under traditional budget analysis rules, ETHA would cost $359 million over five years and about $2.5 billion over 10 years. Taking into account other possible benefits and savings under ETHA, including $192.8 million in costs resulting from a declining death rate and more people staying on Medicaid, the "true cost" of ETHA is $55.2 million over five years, saving $31.7 million over 10 years, according to the study (TAEP release, 7/2).