WHO South-East Asia Journal of Public Health
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POLICY AND PRACTICE
Year : 2017  |  Volume : 6  |  Issue : 1  |  Page : 94-98

Delivery of antiretroviral treatment services in India: Estimated costs incurred under the National AIDS Control Programme


1 Formerly National AIDS Control Organisation, New Delhi, India
2 World Health Organization Country Office for India, New Delhi, India
3 State TB Cell, Revised National Tuberculosis Control Programme, Bangalore, India
4 Employees' State Insurance Corporation Medical College and PGIMSR, Bangalore, India
5 National AIDS Control Organisation, New Delhi, India

Correspondence Address:
Sharath Burugina Nagaraja
Employees' State Insurance Corporation Medical College and PGIMSR, Bangalore
India
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DOI: 10.4103/2224-3151.206172

PMID: 28597866

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Competing domestic health priorities and shrinking financial support from external agencies necessitates that India’s National AIDS Control Programme (NACP) brings in cost efficiencies to sustain the programme. In addition, current plans to expand the criteria for eligibility for antiretroviral therapy (ART) in India will have significant financial implications in the near future. ART centres in India provide comprehensive services to people living with HIV (PLHIV): those fulfilling national eligibility criteria and receiving ART and those on pre-ART care, i.e. not on ART. ART centres are financially supported (i) directly by the NACP; and (ii) indirectly by general health systems. This study was conducted to determine (i) the cost incurred per patient per year of pre-ART and ART services at ART centres; and (ii) the proportion of this cost incurred by the NACP and by general health systems. The study used national data from April 2013 to March 2014, on ART costs and non-ART costs (human resources, laboratory tests, training, prophylaxis and management of opportunistic infections, hospitalization, operational, and programme management). Data were extracted from procurement records and reports, statements of expenditure at national and state level, records and reports from ART centres, databases of the National AIDS Control Organisation, and reports on use of antiretroviral drugs. The analysis estimates the cost for ART services as US$ 133.89 (?8032) per patient per year, of which 66% (US$ 88.66, ?5320) is for antiretroviral drugs and 34% (US$ 45.23, ?2712) is for non-ART recurrent expenditure, while the cost for pre-ART care is US$ 33.05 (?1983) per patient per year. The low costs incurred for patients in ART and pre-ART care services can be attributed mainly to the low costs of generic drugs. However, further integration with general health systems may facilitate additional cost saving, such as in human resources.


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