Recurrent costs of HIV/AIDS-related health services in Rwanda: implications for financing.
OBJECTIVE
To estimate recurrent costs per patient and costs for a national HIV/AIDS treatment programme model in Rwanda.


METHODS
A national HIV/AIDS treatment programme model was developed. Unit costs were estimated so as to reflect necessary service consumption of people living with HIV/AIDS (PLWHA). Two scenarios were calculated: (1) for patients/clients in the year 2006 and (2) for potential increases of patients/clients. A sensitivity analysis was conducted to test the robustness of results.


RESULTS
Average yearly treatment costs were estimated to amount to 504 US$ per patient on antiretroviral therapy (ART) and to 91 US$ for non-ART patients. Costs for the Rwandan HIV/AIDS treatment programme were estimated to lie between 20.9 and 27.1 million US$ depending on the scenario. ART required 9.6 to 11.1 million US$ or 41-46% of national programme costs. Treatment for opportunistic infections and other pathologies consumed 7.1 to 9.3 million US$ or 34% of total costs.


CONCLUSIONS
Health Care in general and ART more specifically is unaffordable for the vast majority of Rwandan PLWHA. Adequate resources need to be provided not only for ART but also to assure treatment of opportunistic infections and other pathologies. While risk-pooling may play a limited role in the national response to HIV/AIDS, considering the general level of poverty of the Rwandan population, no appreciable alternative to continued donor funding exists for the foreseeable future.
Quentin
Wilm
W
Health Economics Research Unit, Department of Psychiatry, University of Leipzig, Leipzig, Germany. WilmQu@gmail.com
König
Hans-Helmut
HH
Schmidt
Jean-Olivier
JO
Kalk
Andreas
A
D015492:AIDS Serodiagnosis / Q000191:economics*; D044966:Anti-Retroviral Agents / Q000191:economics* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000191:economics; D003906:Developing Countries / Q000191:economics*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics*; D015497:HIV-1; D017048:Health Care Costs; D006301:Health Services Needs and Demand / Q000191:economics; D006801:Humans; D008297:Male; D012432:Rwanda
D044966:Anti-Retroviral Agents