The annual costs of treatment of HIV by stage of disease (Table 4.4.2) were converted to Year 2000 prices, where required, by application of the relevant CPI ratio. These were then applied to the number of survivors in each stage. Detailed figures of the results are provided in Table 4.4.3 (See Appendix D).

Figure 4.6 illustrates the annual costs of treatment for the diagnosed cases of HIV avoided as a result of the ten year investment in NSPs. Annual treatment costs rise progressively to the year 2008 as patients progress to later stages of the disease, at which time they peak at approximately $269 million. Thereafter, annual costs decline, brought about mainly by the declining number of patients in the second and third stages of HIV.

Cumulative HIV treatment costs avoided over the lifetime of consumers are illustrated in Figure 4.7. Costs accumulate throughout the lifetime of survivors, but at a slower rate after about 2008.

4.6.1 HCV treatment costs

Figure 4.6 Annual costs of treatment of diagnosed cases of HIV avoided by NSPs (Not discounted)

Text equivalent below for Figure 4.6 Annual costs of treatment of diagnosed cases of HIV avoided by NSPs (Not discounted)
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Text version of Figure 4.6

Figures in this description are approximate as they have been read from the graph.

Figure 4.6 consists of four graphs:
  • Total HIV costs avoided: this increases sharply from close to 0 in 1991 to $270,000,000 in 2009, before decreasing rapidly to less than $10,000,000 by 2060 and remains stable to 2069.

  • CDV4 greater than 500: increases gradually from less than $10,000,000 in 1991 to $15,000,000 in 1997, before spiking to $80,000,000. The cost of treatment then decreases sharply to less than $10,000,000 by 2012 and remains less than $10,000,000 for all years to 2069.

  • CDV4 less than 500: remains at less than $10,000,000 from 1991 to 1998, before increasing sharply to $130,000,000 in 2008 and decreasing gradually less than $10,000,000 by 2051, remaining stable to 2069.

  • AIDS: increases gradually from less than $10,000,000 in 1991 to $145,000,000 in 2012 and decreasing gradually less than $10,000,000 by 2057, remaining stable to 2069.

Figure 4.7 Cumulative costs of treatment of diagnosed cases of HIV avoided by NSPs (Not discounted)

Text equivalent below for Figure 4.7 Cumulative costs of treatment of diagnosed cases of HIV avoided by NSPs (Not discounted)
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Text version of Figure 4.7

Figures in this description are approximate as they have been read from the graph.

Figure 4.7 consists of two graphs
  • Cumulative NSP expend: this slowly increases from about $0 in 1991 to about $1 million in 2002.

  • Cumulative HIV costs avoided: this slowly increases from about $0 in 1991 to about $2 million in 2002, and then increases more steadily to about $6 billion in 2030. The costs avoided then increases more slowly to about $7 billion in 2054, before remaining steady at about $7 billion for subsequent years.

4.6.1 HCV treatment costs

The annual costs of treatment of HCV by stage of disease (Table 4.5.1) were converted to Year 2000 prices, where required, by application of the relevant CPI ratio. These were then applied to the number of diagnosed survivors in each stage of the disease. Detailed figures of the results are provided in Table 4.4.3 (See Appendix D).

Figure 4.8 illustrates the annual costs of treatment for the diagnosed cases of HCV avoided as a result of the ten year investment in NSPs. Annual treatment costs rise progressively to the year 2040, at which time they peak at approximately $18.8 million and decline thereafter. The major factor influencing this cost profile is the number of patients with liver failure who, while relatively small in number, have extremely high costs of treatment.

Cumulative costs of treatment of HCV are presented in Figure 4.9. Costs accumulate throughout the period as patients progress through stages of HCV, reaching a plateau in the late 2050s. The shapes of the curves for both annual and cumulative costs of HIV and HCV treatment are indicative of the different rates of progression through each disease, with progression in HCV occurring at a much slower rate than for HIV, and hence treatment for later stages of the disease peaking much later for HCV than for HIV. This deferral has implications for the determination of the Net Present Values of this expenditure, as discussed below.

Overall, total treatment costs avoided over the life of the cases of HIV and HCV avoided by NSPs are approximately $7,808 million (before discounting). The costs of HIV treatment avoided are approximately ten times those for HCV, which reflects a combination of the number of cases avoided in the first instance (25,000 for HIV compared to 21,000 for HCV), a higher diagnosis rate for HIV than HCV, and higher average annual treatment costs for HIV than for HCV.
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Figure 4.8 Annual costs of treatment of diagnosed cases of HCV avoided by NSPs (Not discounted)

Text equivalent below for Figure 4.8 Annual costs of treatment of diagnosed cases of HCV avoided by NSPs (Not discounted)

Text version of Figure 4.8

Figures in this description are approximate as they have been read from the graph.

Figure 4.8 consists of 6 graphs:
  • Stage 0/1: increases gradually from $800,000 in 1991 to $1,900,000 in 2001, before decreasing very gradually to $100,000 in 2066, remaining stable to 2075.

  • Stage 2/3: increases very gradually from $100,000 in 1991 to $800,000 in 2036, before decreasing very gradually to $100,000 in 2060, remaining stable to 2075.

  • Cirrhosis: increases very gradually from $100,000 in 1991 to $800,000 in 2036, before decreasing very gradually to $100,000 in 2063, remaining stable to 2075.

  • Liver failure: increases dramatically from $100,000 in 1991 to $14,000,000 in 2042, before decreasing dramatically to $100,000 in 2072.

  • Total costs avoided: increases dramatically from $100,000 in 1991 to $18,500,000 in 2040, before decreasing dramatically to $100,000 in 2072.
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Figure 4.9 Cumulative costs of treatment of diagnosed cases of HCV avoided by NSPs (Not discounted)

Text equivalent below for Figure 4.9 Cumulative costs of treatment of diagnosed cases of HCV avoided by NSPs (Not discounted)

Text version of Figure 4.9

Figures in this description are approximate as they have been read from the graph.

The graph in Figure 4.9 shows a gradual increase from $0 in 1991 to about $780 million in 2064, and remains at about that level for subsequent years until 2070.
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