Cost of Receiving Antiretroviral Therapy in the Northeast Thailand - From the Patients' Perspective

Posted: 17 Jun 2007

See all articles by Tsutomu Kitajima

Tsutomu Kitajima

Kyorin University

Yasuki Kobayashi

The University of Tokyo

Nonglak Pagaiya

affiliation not provided to SSRN

Hajime Sato

University of Tokyo

Satoshi Toyokawa

University of Tokyo

Kittisuk Nasungchon

affiliation not provided to SSRN

Abstract

Rationale: International as well as domestic resource mobilization has improved access to antiretorvial therapy (ART) among the people living with HIV/AIDS (PLHA) in developing countries. Thailand is one of such countries where most of the PLHA now have access to free ART by National Access to Antiretroviral Program for People living with HIV/AIDS (NAPHA). However, free access to ART does not mean free to every PLHA.

Objectives: The objectives of this paper is to estimate the cost of receiving ART among PLHA from the patients' perspective.

Methodology:The study was conducted at a general hospital located in a rural part of Northeast Thailand. We collected the data from 180 HIV positive patients with the structured questionnaire at the outpatient department from October 2004 to August 2005. The questionnaire included the questions such as sex, age, health insurance, occupation, monthly income, transportation and its cost between their residence and the hospital, and the amount of the income lost due to the hospital visit. Each participant was also asked if someone accompanied him/her to the hospital and the amount of his/her income lost due to the visit. The respondents were also asked about the reasons why they chose the hospital. In this study, the cost of receiving ART was calculated by adding transportation cost and the income lost due to the hospital visit. We analyzed 164 patients who received ART at the time of the study. We performed ANOVA and t-test to analyze the differences of average cost by the patients with different characteristics. US$1 is equivalent to 37 Baht.

Results: The average and median costs of receiving ART were 414 Baht (SD=574) and 220 Baht, respectively. The average and median proportions to their reported monthly income were 11.3% and 5.0%, respectively. The average cost of those working in the formal sector (678 Baht) was significantly higher than that of those in the informal sector (421 Baht) and the unemployed (206 Baht), p<0.01. One hundred two respondents chose to come to the hospital because they were afraid of revealing their HIV status in their neighborhood if they went to a hospital nearby their residence. Consequently, their average cost of receiving ART (494 Baht) was significantly higher than that of their counterparts (278 Baht), p<0.05.

Conclusion: NAPHA has increased the number of health facilities providing ART free of charge to PLHA in Thailand. However, the study results indicated that it still cost to receive ART from the patients' perspective and that fear of discrimination might have increased the cost. Public health education to stop discrimination against PLHA needs to be strengthened to further improve access to ART among PLHA.

Keywords: HIV/AIDS, cost, anti-retroviral theraphy

JEL Classification: I18

Suggested Citation

Kitajima, Tsutomu and Kobayashi, Yasuki and Pagaiya, Nonglak and Sato, Hajime and Toyokawa, Satoshi and Nasungchon, Kittisuk, Cost of Receiving Antiretroviral Therapy in the Northeast Thailand - From the Patients' Perspective. iHEA 2007 6th World Congress: Explorations in Health Economics Paper, Available at SSRN: https://ssrn.com/abstract=994196

Tsutomu Kitajima (Contact Author)

Kyorin University ( email )

476 Miyashitacho
Hachioji, Tokyo 1928508
Japan

HOME PAGE: http://www.kyorin-u.ac.jp

Yasuki Kobayashi

The University of Tokyo ( email )

7-3-1 Hongo
Bunkyo-ku
Tokyo, 1130033
Japan

Nonglak Pagaiya

affiliation not provided to SSRN ( email )

No Address Available

Hajime Sato

University of Tokyo ( email )

Yayoi 1-1-1
Bunkyo-ku
Tokyo, Tokyo 113-8657
Japan

Satoshi Toyokawa

University of Tokyo ( email )

Yayoi 1-1-1
Bunkyo-ku
Tokyo, Tokyo 113-8657
Japan

Kittisuk Nasungchon

affiliation not provided to SSRN ( email )

No Address Available

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