Cost to the general scheme of the health insurance fund and distinctive features of the outpatient population treated with antiretroviral therapy in 2000 in metropolitan France.

Aims: To determine the number of patients treated with antiretroviral agents purchased from community-based, private chemists and to assess the global reimbursement costs for the general scheme of the French health insurance fund. Method: We performed a cross-sectional survey by using reimbursement data from the general scheme of the French health insurance fund stricto sensu . We enrolled all patients who were reimbursed for at least one antiretroviral agent they had purchased from a city-based, private chemist during the last quarter of 2000. Results: We enrolled a total of 11,890 patients whose average age was 39.5 years. The male-female sex ratio was 2.7. Nearly all the patients (96,3 %) were waived from co-payments since their illness figured on the list of long-term disorders which are reimbursed 100 % by the healthfund. One-half of the patients did not file any reimbursement request for a hospitalization during the year 2000. The healthfund reimbursed an average of 12,404 euros per patient over the year including 8,263 euros for medications. Average expenditures for patients receiving antiretroviral agents were nearly 11 times the expenditures for the average beneficiary in the general population. Medication costs for these patients were 39 times more than in the population in general. Conclusion: This type of easily reproducible study can enable the healthfund to carefully follow changes in care related to HIVpositive patients, particularly with respect to the out-patient medications they purchase. These data can be complemented by data from mandatory HIV reporting as well as from information concerning patients receiving in-patient hospital care. The development of a drug-coding system for medications delivered by hospitals will eventually enable us to follow the entire population of patients treated with antiretroviral drugs in France.