ETUDE SUR LES MODIFICATIONS DES TERMES DE L'AUTORISATION DE MISE SUR LE MARCHE (COMPARAISON UNION EUROPEENNE (UE), ETATS-UNIS (EU) : APPLICATION AU CAS PRATIQUE D'UN TRANSFERT DE PRODUCTION)

CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.

BACKGROUND:Viral load testing is considered the gold standard for monitoring HIV treatment; however, given its high cost, some patients cannot afford viral load testing if this testing is not subsidized. Since foreign aid for HIV/AIDS in Vietnam is rapidly decreasing, we sought to assess willingness to pay (WTP) for viral load and CD4 cell count tests among HIV-positive patients, and identified factors that might inform future co-payment schemes. METHODS:A multi-site cross-sectional survey was conducted with 1133 HIV-positive patients on antiretroviral therapy (ART) in Hanoi and Nam Dinh. Patients' health insurance coverage, quality of life, and history of illicit drug use were assessed. A contingent valuation approach was employed to measure patients' WTP for CD4 cell count and viral load testing. RESULTS:HIV-positive patients receiving ART at provincial sites reported more difficulty obtaining health insurance (HI) and had the overall the poorest quality of life. Most patients (90.9%) were willing to pay for CD4 cell count testing; here, the mean WTP was valued at US$8.2 (95$) per test. Most patients (87.3%) were also willing to pay for viral load testing; here, mean WTP was valued at US$18.6 (95$) per test. High income, high education level, and hospitalization were positively associated with WTP, while co-morbidity with psychiatric symptoms and trouble paying for health insurance were both negatively related to WTP. CONCLUSIONS:These findings raise concerns that HIV-positive patients in Vietnam might have low WTP for CD4 cell count and viral load testing. This means that without foreign financial subsidies, many of these patients would likely go without these important tests. Treating psychiatric co-morbidities, promoting healthcare services utilization, and removing barriers to accessing health insurance may increase WTP for monitoring of HIV/AIDS treatment among HIV+-positive Vietnamese patients

Health insurance among participants.

<p>Health insurance among participants.</p

Socio-demographic characteristics of respondents based on recruitment site.

<p>Socio-demographic characteristics of respondents based on recruitment site.</p

The Bidding process, based on the contingent valuation model.

<p>(A) Bidding process to measure WTP for CD4 cell count; (B) Bidding process to measure WTP for Viral load test. <i>Note</i>: *<i>N indicates unwillingness to pay; Y indicates willingness to pay</i>.</p

Participants’ physical and mental health status, intravenous drug abuse history, and drug abuse treatment history.

<p>Participants’ physical and mental health status, intravenous drug abuse history, and drug abuse treatment history.</p

Characteristics of the centers providing HIV/AIDS monitoring and treatment that were included in this study.

<p>Characteristics of the centers providing HIV/AIDS monitoring and treatment that were included in this study.</p

Willingness to pay for HIV treatment monitoring—CD4 & VIRAL LOAD.

<p>Willingness to pay for HIV treatment monitoring—CD4 & VIRAL LOAD.</p