Ten-Year Cost Projections for Medicare Beneficiaries 65 Years or Older With HIV

Over the next decade, what will be the costs associated with Medicare beneficiaries aged 65 years or older with HIV, including antiretroviral therapy (ART) costs?In this economic evaluation using microsimulation modeling with 111 600 Medicare beneficiaries with HIV at model start, the number of beneficiaries aged 65 years or older receiving care for HIV is projected to increase from 121 890 at the end of 2026 to 193 560 at the end of 2035. Given current ART costs and health care–associated inflation, 10-year cumulative costs to Medicare would be $187.2 billion; however, reducing ART costs by 60% could lower Medicare spending by 38%.These findings suggest that nearly 200 000 people aged 65 years or older with HIV would be enrolled in Medicare by 2035; reducing ART costs while maintaining access to high-quality ART is critical.

Corresponding Author: Emily P. Hyle, MD, MSc, Division of Infectious Diseases, Massachusetts General Hospital, 100 Cambridge St, 16th Floor, Boston, MA 02114 (ehyle@mgh.harvard.edu).

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