The cost of treating HIV/AIDS is likely to escalate to a staggering $12.1 billion a year, and drug therapy will make up nearly three-quarters of that total, according to a study published in the November issue of the journal Medical Care.

The findings should be used by healthcare policymakers to ensure that there is no shortfall in funding for the care of HIV, according to the authors, led by Bruce Schackman of Weil Cornell Medical College.

"Policy makers need accurate and up-to-date predictions of the future expense of HIV treatment if they seek to ensure broad access to high-quality care," said Schackman. "If they rely on outdated cost information, treatment programs will be under-funded and the economic value of HIV prevention will be understated."

The study estimates that a typical patient with HIV has a life expectancy of 24.2 years from the point that treatment is started.

“From the time of entering HIV care the undiscounted cost is $618,900 for adults who initiate antiretroviral therapy with a CD4 cell count of less than 350/uL,” they write. 73% of that cost is for antiretroviral medications, 13% for inpatient care, 9% for outpatient care and 5% other HIV-related medications and laboratory costs.

When HIV care costs are discounted to reflect the fact that they will be incurred in the future, the projected lifetime cost per person at the time of entering optimal HIV care is $385,200, and the treatment expense that can be avoided by preventing each HIV infection is $303,100.

For patients who initiate ART with CD4 cell count of less than 200/uL, projected life expectancy is 22.5 years, discounted lifetime cost is $354,100 and undiscounted cost is $567,000, they add.

The Centers for Disease Control and Prevention estimate that about 40,000 people become infected with HIV every year in the USA, and up to 250,000 do not even know they are infected.