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HIV/AIDS Costliest Chronic Condition Cluster in US Analysis

February 12, 2021

Among nearly 1.9 million US patients covered by Medicare, Medicaid, or commercial insurance, half had multiple chronic conditions, according to a study published online in Frontiers in Public Health. HIV/AIDS was the costliest cluster, averaging $48,293 a year per patient. 

The finding stems from a cross-sectional analysis of US financial claims data for 2015. Researchers were interested in quantifying health care spending in patients with common clusters of conditions. 

According to the study, metabolic syndrome was the most common cluster, affecting 12.2% of insured patients. Next were age-related diseases, which affected 7.7% of patients; renal failure, 5.6%; respiratory disorders, 4.5%; cardiovascular disease, 4.3%; cancers, 4.1% to 4.3%; and mental health-related clusters, 1% to 1.5%. HIV/AIDS ranked lowest, at 0.2%. 

Yet the HIV/AIDS cluster, which included hypertension, high cholesterol, alcohol abuse, depression, and weight loss, was the costliest cluster included in the study. Averaging $21,866 per year per patient, branded drugs accounted for 45.3% of the annual $48,293 cost per patient, researchers reported. 

After HIV/AIDS, the clusters with the most spending were mental health-related clusters ($38,952–$40,637 per patient per year), renal disease ($38,551 per patient per year), and cardiovascular disease ($37,155 per patient per year). 

“The relatively recent phenomenon of co-existence and clustering of chronic communicable conditions, such as HIV, with highly-prevalent noncommunicable diseases, represents a serious threat for a failure of management of these conditions and increase in their prevalence, further complicated by poor health care access,” researchers wrote. “Learnings from the successful delivery of HIV programs may be relevant to develop multiple disease frameworks, such as integrated care for noncommunicable diseases and HIV in Kenya and medication adherence clubs.” 

Jolynn Tumolo


Hajat C, Siegal Y, Adler-Waxman A. Clustering and Healthcare Costs With Multiple Chronic Conditions in a US Study. Front Public Health. 2021;8:607528. Published 2021 Jan 21. doi:10.3389/fpubh.2020.607528

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