Q&A: Medicare spending on clinical care for people aging with HIV projected to rise steeply over next decade

Bar Graphs of Model-Projected Numbers and Costs of Medicare Beneficiaries Aged 65 Years or Older Receiving Care for HIV (2026-2035). Credit: JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.21966

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.

Emily P. Hyle, MD, and Kenneth A. Freedberg, MD, of the Medical Practice Evaluation Center within the Department of Medicine at Mass General Brigham, are the lead and senior authors of a paper published in JAMA Network Open, "Ten-Year Cost Projections for Medicare Beneficiaries 65 Years or Older With HIV."

What challenges or unmet needs make this study important?

Survival among people with HIV in the United States continues to improve due to highly effective antiretroviral therapy (ART), a lifelong treatment. As a result, costs to Medicare are expected to rise substantially as more adults with HIV live long enough to age into the program. However, it has been largely unknown how much the number of Medicare beneficiaries may increase over the next decade and how much the program's spending could rise.