The Economics of Effective AIDS Treatment : Evaluating Policy Options for Thailand
The purpose of this report is to advise the Thai government and Thai society at large about the full range of benefits, costs, and consequences that are likely to result from the decision to expand public provision of antiretroviral therapy (ART) t...
| Main Authors: | , , , , , , |
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| Other Authors: | |
| Format: | Publication |
| Language: | English en_US |
| Published: |
Washington, DC: World Bank
2012
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2006/01/7082805/economics-effective-aids-treatment-evaluating-policy-options-thailand http://hdl.handle.net/10986/7196 |
| Summary: | The purpose of this report is to advise
the Thai government and Thai society at large about the full
range of benefits, costs, and consequences that are likely
to result from the decision to expand public provision of
antiretroviral therapy (ART) through National Access to
Antiretroviral Program for People Living with HIV/AIDS
(NAPHA) and to assist with the design of implementation
policies that will achieve maximum treatment benefits, while
promoting prevention of HIV/AIDS and maintaining financial
sustainability within Thailand. The study has several
significant findings: NAPHA with first-line regimen only is
the most cost-effective policy option of those studied;
NAPHA with second-line therapy is still affordable and
yields large benefits in terms of life-years saved; policy
options to enhance adherence and to recruit patients earlier
are a good public investment; public financing will help
ensure equitable access; public financing can strengthen
positive spillovers and can limit negative spillovers of
ART; if the success of ART rollout makes people or the
government complacent about prevention, future costs could
rise substantially; and future government expenditures on
ART, and the lives it will save are highly sensitive to
negotiated agreements on the intellectual property rights
for pharmaceuticals. In its current form, Thailand's
NAPHA program is affordable. Under the model's
assumptions, it is also cost-effective relative to the
baseline scenario. Furthermore, although the two enhanced
policies we suggest early recruitment through expanded
voluntary counseling and testing (VCT) and improved
adherence through Person living with HIV/AIDS (PHA) groups
are less cost-effective, they are still a good bargain,
particularly if both are enacted. |
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