The Economics of Effective AIDS Treatment: Evaluating Policy Options for ThailandHIV is the leading cause of premature death in Thailand. Since the first case of AIDS was reported in 1984 more than one million Thais have been infected. The social, human and economic costs of this burden are enormous. The Thai government has shown a strong commitment to providing care and support to persons living with HIV/AIDS by launching the National Access to Care Program (NAPHA) in 2003, which provides for publicly financed antiretroviral therapy (ART) to all HIV-infected people. This book documents through interviews how ART has radically changed the lives of those living with HIV. In the words of an HIV positive 29-year old man, ART is a "miracle." The book then develops an innovative analytical framework and uses it to show how the future sustainability and cost-effectiveness of this ambitious program depend critically on Thai government choices of AIDS treatment policy, HIV prevention policy and AIDS drug pricing. For the most likely assumptions, the book estimates that ART will save years of healthy life at a cost of between $700 and $2,400 per year. Successful AIDS treatment accumulates ever-increasing numbers of patients who need subsidized ART. Despite the magnitude of the resulting fiscal burden, the authors judge this expenditure to be a worthwhile public health investment for Thailand, However, they show that the future sustainability of the program will hinge critically on how well the government manages the quality of ART service delivery, on whether it is able to sustain its past successes in HIV prevention and on its negotiations with multinational pharmaceutical manufacturers on the prices of new AIDS drugs. |
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additional adherence AIDS alternative analysis Annual antiretroviral assume assumptions augmented public Authors average baseline begin behavior benefits budget CD4 count cells per cubic chapter clinical compared condom cost cost of ART cost-effectiveness countries cubic millimeter death demand disease drugs early effect epidemic estimated expanded expenditure facilities Figure finance first-line therapy function groups HIV infections HIV/AIDS hospital household improved increase infections initial late less life-year saved living male million mode month MOPH NAPHA policy Note options patients percent period person population prevalence prevention progression projected recruitment reduced regimens resistance response result risk scenario second-line therapy sector sex workers Share shows Source strains symptomatic Table testing Thai Thailand transmission treat treatment World
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Page 30 - NRTI, nucleoside reverse transcriptase inhibitor; NNRTI , non-nucleoside reverse transcriptase inhibitor; PI, protease inhibitor •Refer to drug reference for specific dosing and other considerations Adapted from Wilkes G, Williams A.
Page 69 - Increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical...
Page 20 - AIDS policy under the co-ordination of the Office of the Prime Minister with a multisectoral National AIDS Prevention and Control Committee chaired by the prime minister. This signalled the high level of political commitment and encouraged sectors other than health to become involved.
Page 69 - WHO reports that studies consistently find significant cost savings and increases in the effectiveness of health interventions that are attributable to low-cost interventions for improving adherence.
Page 159 - India to comply with the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property...
Page 45 - ... becoming fewer. Hence, the scope and complexity of the standards management system and the diversity of the areas of societies with which it must interact will progressively enlarge. The time frame within which the need for a standard must be met by production of a suitable standard will vary from as short as a few weeks to as long as a few years. The voluntary standards-making system must include provisions for the employment of expedited procedures when such are needed. The keystone of any...
Page 23 - This process took advantage of the experience in HIV/AIDS prevention and care gained in the first decade of the Thai epidemic.
Page 28 - Treatment of common opportunistic infections (such as tuberculosis, pneumocystis carinii pneumonia, and cryptococcal meningitis...
Page 19 - NGO, and private initiatives, including measures for program management, health education, counseling, training, surveillance, monitoring, medical and social care, and laboratory and blood safety control.
Page xxi - The first case of AIDS in Thailand was reported in September 1984.