title: The cost of antiretroviral treatment service for patients with HIV/AIDS in a central outpatient clinic in Vietnam.
abstract: BACKGROUND
  Antiretroviral treatment (ART) services are estimated to account for 30% of the total resources needed for human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) control and prevention in Vietnam during the 2011-2020 timeframe. With international funding decreasing, determining the total cost of HIV/AIDS treatment is necessary in order to develop a master plan for the transition of ART services delivery and management. We analyzed the costs of HIV/AIDS treatment paid by both HIV programs and patients in a central outpatient clinic, and we explored factors associated with the capacity of patients to pay for this service.
  
  
  METHODS
  Patients (n=315) receiving ART in the Department of Infectious Diseases at Bach Mai Hospital, Hanoi, Vietnam, were interviewed. Patient records and expenses were reviewed.
  
  
  RESULTS
  The total cost of ART per patient was US$611 (75% from health care providers, 25% from patients or their families). The cost of a second-line regimen was found to be 2.7 times higher than the first-line regimen cost. Most outpatients (73.3%) were able to completely pay for all of their ART expenses. Capacity to pay for ART was influenced by five factors, including marital status, distance from house to clinic, patient's monthly income, household economic condition, and health insurance status. Most of the patients (84.8%) would have been willing to pay for health insurance if a copayment scheme for ART were to be introduced.
  
  
  CONCLUSIONS
  This study provides evidence on payment capacity of HIV/AIDS patients in Vietnam and supplies information on ART costs from both provider and patient perspectives. In particular, results from this study suggest that earlier access to ART after HIV infection could dramatically reduce the overall cost of treatment.
authors.affiliation: Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
authors.forename: Long Thanh
authors.initials: LT
authors.lastname: Nguyen
authors.affiliation: Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
authors.forename: Bach Xuan
authors.initials: BX
authors.lastname: Tran
authors.affiliation: Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
authors.forename: Cuong Tuan
authors.initials: CT
authors.lastname: Tran
authors.affiliation: Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
authors.forename: Huong Thi
authors.initials: HT
authors.lastname: Le
authors.affiliation: Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
authors.forename: Son Van
authors.initials: SV
authors.lastname: Tran
keywords: antiretroviral therapy; developing countries; health care cost; human immunodeficiency virus infection; opportunity cost