Research Activities #288, August 2004

disease are much less likely than men with HIV to receive potentially lifeprolonging drugs even though they have private health insurance that would help pay for the drugs, according to a recent study from the Agency for Healthcare Research and Quality. Fred J. Hellinger, Ph.D., and William E. Encinosa, Ph.D., of AHRQ’s Center for Delivery, Organization, and Markets, found that only 39 percent of women with HIV disease enrolled in the health insurance plans of 24 large employers across the country were provided antiretroviral drugs for HIV disease in 2000, compared with 71 percent of men with HIV enrolled in the same plans. Access to these drug therapies is linked to increased survival and a higher quality of life for individuals with HIV disease. The researchers further found that among adults treated with antiretroviral therapy, women (31 percent) were only half as likely as men (63 percent) to be prescribed the newer, more effective, and more costly protease inhibitor and/or nonnucleoside reverse transcriptase inhibitor drugs. Therapy involving these two types of drugs, which were approved for use after 1995, is known as highly active antiretroviral therapy or HAART. This disparity in prescribing for men and women was reflected in prescription drug expenditures. The average annual drug expenditure for men, $9,037, was more than twice the $3,893 spent for women’s medications. Women, on average, had total health care expenditures of $10,397 in 2000, while total health care expenditures for men averaged $16,405 that year. Almost all of this difference resulted from lower payments for drugs for women with HIV disease. The findings from this study are surprising, since the study participants were privately insured and should have had equal access to drug therapies, note Drs. Hellinger and Encinosa. They point out that the reasons behind the disparity Research Activities