CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Conclusions: Uninsured and underinsured HIV-infected persons receiving RWHAP assistance were more likely to be prescribed ART and virally suppressed than those with some other types of healthcare coverage. 1065 Combining Multisite Payor DataWith Clinical Data to Quantify Medicaid Payments for HIV Care Anne Monroe 1 ; CindyVoss 1 ; Richard Moore 1 ; Kelly Gebo 1 ; Allison Agwu 1 ; Richard Rutstein 3 ;Victoria Sharp 5 ; Stephen Boswell 4 ; John Fleishman 2 The HIV Research Network 1 Johns Hopkins University School of Medicine, Baltimore, MD, US; 2 Agency for Healthcare Research and Quality, Rockville, MD, US; 3 The Children’s Hospital of Philadephia, Philadelphia, PA, US; 4 Fenway Health, Boston, MA, US; 5 Wyckoff Heights Medical Center, Brooklyn, NY, US Background: Costs of care for persons living with HIV (PLWH) have been high historically and may increase as the HIV-infected population ages. Cost estimates based on data from one health care site likely underestimate total expenditures; using insurance claims avoids this limitation. We used Medicaid claims data to comprehensively measure payments for care for PLWH. Methods: Six sites from the HIV Research Network (HIVRN) participated. Medicaid data were obtained from the sites’ states (MD, PA, NY, and MA) and 3 surrounding states per site and matched to HIVRN medical record-based data. Individuals less than 18 and those with Medicare and Medicaid were excluded. Adjusted regression analyses were performed to examine the relationship between total payments and HIVRN demographic and clinical variables. Results: 6,892 unique identifiers from the HIVRN were submitted; 6,160 (89.4%) had a match in the Medicaid data. The data set included 13,492 person-years of Medicaid insurance claims data from 4,909 adults (66%male; 57% Black, 20% Hispanic, and 15%white; 29% IDU, 28%MSM, 37% HET; median age 44 years, range 18-76) with baseline CD4 cell count of ≤ 200, 200-500 and ≥ 500 cells/mm 3 in 27%, 43%, and 30%. Mean payment PPY increased over time from $42,914 in 2006 to $47,094 in 2010 (9.7% increase, inflation was 8.2%). Mean payment PPY for patients aged < 50 was $41,061 and for patients aged ≥ 50 was $51,868. Mean payment PPY for patients with CD4 count ≤ 200, 201-499, and >500 cells/mm 3 was $60,000, $42,390, and $35,932. Higher payments for older vs. younger patients in the two highest CD4 cell count categories were observed (p=0.007). Drug payments PPY averaged $12,566 in 2006 and $20,005 in 2010. Overall, ART payments comprised 50% of total drug payments in 2006 and 67% of the total in 2010, with ART payments almost doubling, while payments for inpatient and outpatient care declined significantly. In multivariable linear regression, age category ( ≥ 50 vs. <50 years), CD4 category (both ≥ 500 vs. ≤ 200 and 201-499 vs. ≤ 200), year (2010 vs. 2006) and risk factor (both IDU and HET vs. MSM) were significantly associated with higher payments (p<0.05 for all).

Poster Abstracts

622

CROI 2015