Out-of-Pocket Costs of Aids Care in China: Are Free Antiretroviral Drugs Enough?

AIDS Care, Volume 20, Issue 5, 2008, Page 984-994

Posted: 5 Jun 2018

See all articles by Suerie Moon

Suerie Moon

Harvard University - Harvard Global Health Institute

Yuan Qiong Hu

University of London-School of Oriental and African Studies(SOAS), School of Law

Date Written: September 5, 2008

Abstract

Financial access to HIV care and treatment can be difficult for many people in China, where the government provides free antiretroviral drugs but does not cover the cost of other medically necessary components, such as lab tests and drugs for opportunistic infections. This article estimates out-of-pocket costs for treatment and care that a person living with HIV/AIDS in China might face over the course of one year. Data comes from two treatment projects run by Médecins Sans Frontières in Nanning, Guangxi Province and Xiangfan, Hubei Province. Based on the national treatment guidelines, we estimated costs for seven different patient profiles ranging from WHO Clinical Stages I through IV. We found that patients face significant financial barriers to even qualify for the free ARV program. For those who do, HIV care and treatment can be a catastrophic health expenditure, with cumulative patient contributions ranging from approximately US$200–3939/year in Nanning and US$13–1179/year in Xiangfan, depending on the patient's clinical stage of HIV infection. In Nanning, these expenses translate as up to 340% of an urban resident's annual income or 1200% for rural residents; in Xiangfan, expenses rise to 116% of annual income for city dwellers and 295% in rural areas. While providing ARV drugs free of charge is an important step, the costs of other components of care constitute important financial barriers that may exclude patients from accessing appropriate care. Such barriers can also lead to undesirable outcomes in the future, such as impoverishment of AIDS-affected households, higher ARV drug-resistance rates and greater need for complex, expensive second-line antiretroviral drugs.

Keywords: access to treatment, China, out-of-pocket cost, AIDS

Suggested Citation

Moon, Suerie and Hu, Yuan Qiong, Out-of-Pocket Costs of Aids Care in China: Are Free Antiretroviral Drugs Enough? (September 5, 2008). AIDS Care, Volume 20, Issue 5, 2008, Page 984-994, Available at SSRN: https://ssrn.com/abstract=3174770

Suerie Moon

Harvard University - Harvard Global Health Institute ( email )

104 Mt. Auburn Street, 3rd Floor
Cambridge, MA 02138
United States

Yuan Qiong Hu (Contact Author)

University of London-School of Oriental and African Studies(SOAS), School of Law ( email )

Thornhaugh Street
Russell Square: College Buildings 541
London, WC1H 0XG
United Kingdom

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