Decreasing cost of public sector first-line ART services in India from 2007-2008 to 2015-2016

G Anil Kumar, Rakhi Dandona, Bharat B Rewari, S G Prem Kumar, Sukarma Tanwar, Marielle C Gagnier, Venkata S Vishnumolakala and Lalit Dandona

PLOS ONE, 2018, vol. 13, issue 11, 1-13

Abstract: Introduction: India has scaled-up antiretroviral treatment (ART) in public sector facilities, but data to understand time trends of average cost of ART are limited. Materials and methods: Cost and output data were collected at all public sector ART centres in undivided Andhra Pradesh (high-HIV burden state) and Rajasthan (low-HIV burden state) in India from fiscal year 2007–2008 to 2012–2013. Average cost per patient for first-line ART, and its relation with scale of services, were assessed. Using data on scale of services, the average cost was estimated up to 2015–2016. Break-even point was estimated from average and marginal cost functions. Costs were adjusted to 2015 constant price. Results: The average cost per patient alive and on ART in 2015–2016 was US$162 in undivided Andhra Pradesh and US$186 in Rajasthan, which was 51.4% and 35.8% lower than in 2007–2008, respectively. Average ART drug cost declined by 27.2% during this period, and was 70.9% and 61.5% of the total ART cost in the two states in 2015–2016. The average cost other than ART drugs declined by 73.1% and 45.7%, with the number of patients served increasing 7 and 14.2 times, respectively. Average cost other than ART drugs had a significant negative relation with scale (R2 = 86.4%-82.8%, p

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0206988

DOI: 10.1371/journal.pone.0206988

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