Setting priorities for government involvement with antiretrovirals

An economic analysis to prioritise government involvement with antiretroviral therapy for HIV/AIDS patients

This paper examines four questions posed by economic analysis to help set priorities for government involvement with antiretroviral therapy for people living with HIV/AIDS. The main focus is on making decisions about policy relating to ARVs in developing countries where the needs are greatest and resource constraints are most binding. While the answers may vary considerably depending on individual country circumstances, the analytical foundations for setting priorities are the same:

how does antiretroviral therapy link to broader health sector and country development objectives?
what other interventions need to be considered including the various ARV treatments?
which of these alternatives are realistically affordable given the country’s resource constraints?
which of the affordable alternatives are most efficient in achieving a favourable development impact?

The paper assesses the effectiveness estimates together with the cost figures makes it possible to compare the cost-effectiveness of antiretroviral alternatives (Figure 5). The adult antiretroviral regimes generate around 30 QALYs per million baht of expenditure. In contrast, preventing perinatal transmission appears to produce more than 600 QALYs per million baht, a twentyfold difference.

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Setting priorities for government involvement with antiretrovirals