Analysis of the treatment cost of HIV/AIDS in Turkey

Guvenc Kockaya, Tuba Elbir Zengin, Fatma Betul Yenilmez, Canan Dalgic, Simten Malhan Simten Malhan, Pamir Cerci, Ergun Oksuz, Serhat Unal



OBJECTIVE: Infection with the human immunodeficiency virus (HIV), the causative agent of acquired immune deficiency syndrome (AIDS), is a major global health problem. Patients with HIV can live normal lives with today’s new treatment options. As the treatment is generally successful, the life expectancy of patients infected with HIV is rising. As a result, the economic burden of HIV treatment on health systems is set to increase. According to the Ministry of Health, there were more than 6000 HIV-positive patients in Turkey in 2013. The aim of this study was to determine the direct costs of HIV treatment in Turkey.
METHOD: A retrospective data analysis was performed from the reimbursement agency perspective. Data for 252 patients at a university hospital in Ankara from 2001 to 2012 were used for the analysis. The average costs of treatment per HIV patient and the average costs per HIV patient, depending on the state of the patient’s health, were calculated. The latter was determined according to the number of CD4 cells/ml, as defined by the CDC’s classification system for HIV infection. The cost of treatment was calculated based on published reimbursement prices in 2013, per patient per year.
RESULTS: The CD4 values of 25.3%, 29%, and 45.7% of the 252 patients were <100 cells/mm3, 100–300 cells/mm3, and >300 cells/mm3, respectively. The treatment costs per patient per year for 2013 for those with CD4 values of <100 cells/ mm3, 100–300 cells/mm3, and >300+ cells/mm3 were $ 5,637.04, $ 2,211.54, and $ 2,182.35, respectively. The weighted average of the treatment cost per patient was $ 3,344.64 for 2013.
CONCLUSION: This analysis is unique to Turkey and calculates the cost only of HIV treatment in Turkey. Lower CD4 values are associated with higher treatment costs. Appropriate HIV treatment is crucial for controlling CD4 values and lowering the treatment costs of HIV patients. These findings need to be considered by policy makers who may need to focus on HIV.


HIV/AIDS; Cost of treatment; Turkey

Full Text



  • World Health Organization. Fast Track Ending The AIDS Epidemic by 2030. Available at: (last accessed January 2015)
  • AIDS Cases and its Carriers in Turkey Distribution by years. Available at (last accessed January 2015)
  • Montaner JS, Lima VD, Harrigan PR, et al. Expansion of HAART Coverage Is Associated with Sustained Decreases in HIV/AIDS Morbidity, Mortality and HIV Transmission: The “HIV Treatment as Prevention” Experience in a Canadian Setting. PLoS ONE 2014; 9: e87872;
  • Edward J, Millsa EJ, Bakandab C, et al. Mortality by baseline CD4 cell count among HIV patients initiating antiretroviral therapy: evidence from a large cohort in Uganda. AIDS 2011; 25: 851-5;
  • World Health Organization. Towards Universal Access Scaling up priority HIV/AIDS interventions in the health sector Progress Report, 2010. Available at:, (last accessed January 2015)
  • British HIV Association. British HIV Association guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2012. HIV Medicine 2014; 15 (Suppl. 1): 1-85
  • Marseille E, Hofmann PB, Kahn JG. HIV prevention before HAART in sub-Saharan Africa. Lancet 2002; 359: 1851-56;
  • Creese A, Floyd K, Alban A, et al. Cost-effectiveness of HIV/AIDS interventions in Africa: a systematic review of the evidence. Lancet 2002; 359: 1635-42;
  • Erdem H ve Akova M. Leading infectious diseases problems in Turkey. Clin Microbiol Infect 2012; 18: 1056-67;
  • Hutchinson AB, Farnham PG, Dean HD, et al. The Economic Burden of HIV in the United States in the Era of Highly Active Antiretroviral Therapy Evidence of Continuing Racial and Ethnic Differences. J Acquir Immune Defic Syndr 2006; 43: 451-7
  • Kockaya G, Wertheimer A. What are the top most costly diseases for USA? The alignment of burden of illness with prevention and screening expenditures. Journal of Health 2010; 2: 1174-8;
  • Leibowitz AA, Desmond K. Identifying a Sample of HIV-Positive Beneficiaries From Medicaid Claims Data and Estimating Their Treatment Costs. Am J Public Health 2015; 105: 567-74;
  • Trapero-Bertran M, Oliva-Moreno J. Economic impact of HIV/AIDS: a systematic review in five European countries. Health Economics Review 2014; 4: 15;
  • Schackman BR, Gebo KA, Walensky, RP, et al. The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States. Med Care 2006; 44: 990-7;
  • Edward J, Millsa EJ, Bakandab C, et al. Mortality by baseline CD4 cell count among HIV patients initiating antiretroviral therapy: evidence from a large cohort in Uganda. AIDS 2011; 25: 851-5;
  • Fleishman JA, Yehia BR, Moore RD, et al.; HIV Research Network. The Economic Burden of Late Entry Into Medical Care for Patients With HIV Infection. Med Care 2010; 48): 1071-9;
  • Lima VD, Johnston K, Hogg RS, et al. Expanded access to highly active antiretroviral therapy: a potentially powerful strategy to curb the growth of the HIV epidemic. J Infect Dis 2008; 198: 59-67;


Abstract: 2813 views
HTML: 2559 views
PDF: 408 views


  • There are currently no refbacks.