Incremental healthcare resource utilization and costs among people living with HIV with and without cardiovascular disease, hypertension, and type 2 diabetes mellitus in the United States

Abstract

Objective: To assess incremental all-cause healthcare resource utilization (HCRU) and costs among people living with HIV (PLWH) with and without cardiovascular disease (CVD), hypertension, or type 2 diabetes mellitus (T2DM) in the United States (US). Methods: This retrospective US administrative claims analysis (Jan 2020–Dec 2022, Optum’s de-identified Clinformatics Data Mart Database) included adult PLWH with ≥1 pharmacy claim for anchor antiretroviral therapy (ART) in 2021 (index date: earliest anchor ART claim). PLWH were followed for 12 months or to end of continuous enrollment and stratified based on baseline presence of CVD (yes/no), hypertension (yes/no), or T2DM (yes/no). Differences between groups in all-cause per-person-per-month (PPPM) HCRU and costs (adjusted to 2023 USD) were estimated using multivariable generalized linear models with negative binomial (HCRU) or gamma (cost) distributions, adjusting for baseline characteristics. HIV-specific and comorbidity-specific HCRU and cost models are not reported due to non-convergence. Results: Of 22,402 PLWH identified, 4,917 (21.9%) had CVD, 10,878 (48.6%) hypertension, and 4,562 (20.4%) T2DM. PLWH with versus without the selected comorbidities were older, more likely to be women or Black, and had higher mean Quan-Charlson Comorbidity Index scores and baseline total costs (all p