Варианты потенциального социально-экономического ущерба при различных сценариях лекарственного обеспечения и разных уровнях охвата антиретровирусной терапией людей, живущих с ВИЧ

Инфекционные болезни. 2020. Т. 9. № 2. С. 8–17.

Волкова О. И., Курилович Е. О., Popovich L.

The aim – predict the epidemiological impact of HIV infection in Russia and assess the socio-economic losses to society depending on different scenarios of drug provision. Material and methods. Simulations of differentiated outcomes of the disease and costs with different algorithms and coverage of HIV antiretroviral treatment for the population of Russia with an assessment of potential lost/saved years of life with their monetary expression in the five-years horizon (2019–2023). Results and discussion. Continuous the current treatment algorithm with growth of spending on ARV therapy by 59.4% in the medium-term period (2018–2023) won’t allow hold down HIV epidemic situation in Russia with 60 or 90% coverage: number of people living with HIV will increase by 12.1%, increase cases of death of HIV-infected – 35.4%. However, the expansion of treatment coverage to 90% of people living with HIV with a qualitative change in the treatment algorithm (ratio antiretrovirals first, second line and combined 40, 50, and 10%, with an efficiency of 81, 96, 96% respectively) and achievement of virological suppression in 90% of people living with HIV who received treatment, it will potentially allow to save 550.6 thousand years of life and 317.8 billion rubles in monetary terms in a five-year perspective. Conclusion. Switching to 90% coverage with optimized treatment lines already in the medium term will provide a significantly more noticeable social impact than with keeping existing approaches. An additional increase in spending on new-generation antiretrovirals, offset by the increasing effectiveness of the annually used approach, will reduce the social economic burden on the Russian society in the context of HIV/AIDS epidemic.

Keywords: социально-экономический ущерб, эпидемия вич-инфекции, antiretroviral therapy, антиретровирусная терапия, лекарственное обеспечение лиц, живущих с ВИЧ/СПИД, Coverage levels, HIV epidemic, Social-economic damage, drug provision for people living with HIV