Q&A: Medicare spending on clinical care for people aging with HIV projected to rise steeply over next decade
As more Americans with HIV live into older age, Medicare spending on their care is projected to rise dramatically from $10.9 billion in 2026 to $27.3 billion in 2035, with HIV medications accounting for nearly two-thirds of total costs.
The number of Medicare beneficiaries aged 65 and older with HIV is projected to surge from 122,000 in 2026 to around 193,600 by the end of 2035, according to a study published in JAMA Network Open. This dramatic increase in enrollment is expected to push Medicare spending on HIV care from $10.9 billion in 2026 to an estimated $27.3 billion by 2035.
Antiretroviral therapy (ART) costs will account for nearly two-thirds of the total projected spending. The study, led by Dr. Emily P. Hyle and Dr. Kenneth A. Freedberg, utilized simulation modeling to project Medicare costs for older adults with HIV, incorporating data from Medicare claims, publicly available sources, and projections from the CEPAC model.
The research examined various scenarios, including the potential impact of policies to reduce ART costs, such as the Inflation Reduction Act and the anticipated availability of generic dolutegravir in 2031. If ART costs were reduced by 60%, Medicare could potentially save $70.3 billion over the next decade. The study emphasizes the need for clinicians and healthcare systems to prepare for the medical needs of this growing population, which is also at higher risk of comorbidities and polypharmacy.
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