Objective: To estimate the savings and cost of providing highly active antiretroviral therapy (HAART) to adult patients with AIDS under Universal Coverage (UC) in Khon Kaen Province, Thailand.
Design: Micro-costing of outpatient and inpatient services of two referral hospitals, and cost modelling.
Setting: Khon Kaen Regional Hospital and Northeast Regional Infectious Hospital.
Patients: Adult patients who resided in Khon Kaen and made outpatient visits at and/or those who were discharged from those hospitals from 1 December 2001 to 28 February 2002.
Main outcome measure: The average cost per outpatient visit and per inpatient day. Based on these figures, the savings and cost of providing HAART to adult patients with AIDS under UC at outpatient settings in this province were estimated.
Results: The average cost per outpatient visit with and without antiretroviral drugs (ARV) was US$294.2 and US$26.1, respectively. The average cost per inpatient day with and without ARV drugs was US$368.1 and US$43.8, respectively. The net annual cost of HAART was estimated to be US$5 674 629. This is equivalent to 20.0% of the annual UC budget for adults in this province in 2002. Sensitivity analysis and projection to the year 2006 were conducted.
Conclusion: A large increase in the budget would be required to provide HAART to all adult patients with AIDS under UC. However, the sensitivity analysis showed it would be an affordable policy option if low-cost antiretroviral drugs were successfully introduced. This type of analysis would be useful to assess the financial implications of providing HAART in public health systems worldwide.