Home › Research › Health systems and care delivery
Ten-Year Cost Projections for Medicare Beneficiaries 65 Years or Older With HIV
Emily Parker Hyle, Luke Ang, Grace Luu, Parastu Kasaie, Dannie Dai, Florence Ebem, Jessica Phelan, Satoshi Koiso et al.. JAMA Network Open, 2026-07-07
Topic: Risk, prevention and care in population studies
Plain-language summary
The simulated cohort was informed by 111 600 PWH enrolled in Medicare at the start of 2026 (mean [SD] age, 70.9 [5.0] years; 77% male). The analysis found that 121 890 PWH would be enrolled in Medicare and in care by the end of 2026, including 60 390 PWH aged 65 to 69 years, 36 340 aged 70 to 74 years, 17 200 aged 75 to 79 years, and 7970 aged 80 years or older. By the end of 2035, this number would increase to 193 560, with increases in each age category (65-69 years: 70 490; 70-74 years: 62 820; 75-79 years: 38 290; 80 years and older: 21 960). Annual costs to Medicare for PWH aged 65 years or older and receiving care for HIV would increase from $10.9 billion by the end of 2026 to $27.3 billion by the end of 2035. Cumulative costs over 10 years were projected to be $187.2 billion, with 63% of cumulative costs due to antiretroviral therapy (ART). If ART costs are reduced by 60%, Medicare would save $70.3 billion over the next decade; projected savings due to the Inflation Reduction Act and generic ART would be $19.4 billion, accounting for the timing of onset and estimated reductions. Based on uncertainties in the number of Medicare beneficiaries and costs of care, sensitivity analyses found that cumulative costs would range from $103.3 billion to $267.5 billion over the next decade. Conclusions and Relevance: In this economic evaluation using microsimulation modeling, the number of Medicare beneficiaries aged 65 years or older receiving care for HIV was projected to increase substantially over the next decade, resulting in $187.2 billion in 10-year cumulative costs to Medicare. Reducing ART costs by 60% could lead to 38% lower overall Medicare spending for older Medicare beneficiaries with HIV.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Hyle, E. P., Ang, L., Luu, G., Kasaie, P., Dai, D., Ebem, F., et al. (2026). Ten-Year Cost Projections for Medicare Beneficiaries 65 Years or Older With HIV. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2026.21966
Vancouver
Hyle EP, Ang L, Luu G, Kasaie P, Dai D, Ebem F, et al. Ten-Year Cost Projections for Medicare Beneficiaries 65 Years or Older With HIV. JAMA Network Open. 2026. doi:10.1001/jamanetworkopen.2026.21966. PMID: 42412430.
BibTeX
@article{hyle2026-42412430,
author = {Hyle, Emily Parker and Ang, Luke and Luu, Grace and Kasaie, Parastu and Dai, Dannie and Ebem, Florence and Phelan, Jessica and Koiso, Satoshi and others},
title = {{Ten-Year Cost Projections for Medicare Beneficiaries 65 Years or Older With HIV}},
journal = {JAMA Network Open},
year = {2026},
doi = {10.1001/jamanetworkopen.2026.21966},
pmid = {42412430},
url = {https://doi.org/10.1001/jamanetworkopen.2026.21966}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- The simulated cohort was informed by 111 600 PWH enrolled in Medicare at the start of 2026 (mean [SD] age, 70.9 [5.0] years; 77% male).
- The analysis found that 121 890 PWH would be enrolled in Medicare and in care by the end of 2026, including 60 390 PWH aged 65 to 69 years, 36 340 aged 70 to 74 years, 17 200 aged 75 to 79 years, and 7970 aged 80 years or older.
- By the end of 2035, this number would increase to 193 560, with increases in each age category (65-69 years: 70 490; 70-74 years: 62 820; 75-79 years: 38 290; 80 years and older: 21 960).
- Annual costs to Medicare for PWH aged 65 years or older and receiving care for HIV would increase from $10.9 billion by the end of 2026 to $27.3 billion by the end of 2035.
- Cumulative costs over 10 years were projected to be $187.2 billion, with 63% of cumulative costs due to antiretroviral therapy (ART).
Why it matters
This modeling study projected the number of Medicare beneficiaries 65 and older with HIV and their costs over ten years, with most costs due to antiretroviral therapy. It contains no information on treating, curing, or preventing Alzheimer's disease.
Study details
- Effect sizereduced by 60%
- Evidence strengthModerate
How this study scored 43/100
Published in a leading specialty journal. Scored zero for study design, sample size, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA Network Open) |
| Journal's citation record | 2 / 4 | JAMA Network Open: journal h-index 235 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Kenneth A. Freedberg: h-index 75 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42412430) |
| Free to read | 2 / 2 | Free to read |
| Total | 43 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1001/jamanetworkopen.2026.21966
- PubMed: 42412430
- Original source →
- Free full text: JAMA Network Open →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Related
Studies in the library that share something with this one. The line above each title says what.
Related studies in Health systems and care delivery from nearby years
Also tagged “palliative”
858 studies in the library carry the topic tag “palliative”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 858 tagged studies.