Lifetime Cost of HIV Tops $1.1 Million More Than for Individuals Without HIV, Study Finds
A new observational study examining commercially insured adults in the United States has revealed the substantial long-term economic burden associated with HIV, showing that lifetime costs for people with HIV (PWH) exceed those for individuals without HIV by more than $1.1 million when adjusted for present-day value. The analysis, which drew on IQVIA PharMetrics® Plus commercial claims data from 2018 through 2023, compared lifetime costs (LTC), annual expenditures, and health care resource utilization (HCRU) among adults with HIV and a matched non-HIV cohort. Individuals in the HIV group had confirmed diagnoses, evidence of antiretroviral therapy (ART), and continuous enrollment, and were matched 1:3 with individuals without HIV on the basis of age, sex, geographic region, and health plan.
Undiscounted lifetime costs for PWH averaged approximately $2.9 million, compared with about $482 000 for those without HIV, representing an incremental difference of more than $2.4 million. When discounted to 2022 US dollars to reflect present-day value, LTC for PWH totaled approximately $1.3 million, versus $181 000 for the non-HIV group—a difference of nearly $1.12 million. Annual costs for PWH were consistently six to seven times higher than those of individuals without HIV across all years studied, and health care resource use—including inpatient, outpatient, emergency department, and pharmacy utilization—was higher in the HIV group. Older adults with HIV also incurred greater costs relative to younger individuals.
These findings emphasize the sustained financial impact of HIV and the ongoing need for targeted prevention, early treatment, and comprehensive care strategies. For payers, they underscore the potential value of investing in interventions that reduce transmission risk, support adherence, and manage comorbidities to help mitigate long-term costs.
References
Cohen JP, Anupindi VR, Doshi R, et al. Estimation of lifetime costs among insured persons with HIV in the United States. Pharmacoecon Open. Published online June 9, 2025. doi:10.1007/s41669-025-00584-0
