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The economics of effective AIDS treatment : evaluating policy options for Thailand (Thai)

The purpose of this report is to advise the Thai government and Thai society at large about the full range of benefits, costs, and consequences that are likely to result from the decision to expand public provision of antiretroviral therapy (ART) through National Access to Antiretroviral Program for People Living with HIV/AIDS (NAPHA) and to assist with the design of implementation policies that will achieve maximum treatment benefits, while promoting prevention of HIV/AIDS and maintaining financial sustainability within Thailand. The study has several significant findings: NAPHA with first-line regimen only is the most cost-effective policy option of those studied; NAPHA with second-line therapy is still affordable and yields large benefits in terms of life-years saved; policy options to enhance adherence and to recruit patients earlier are a good public investment; public financing will help ensure equitable access; public financing can strengthen positive spillovers and can limit negative spillovers of ART; if the success of ART rollout makes people or the government complacent about prevention, future costs could rise substantially; and future government expenditures on ART, and the lives it will save are highly sensitive to negotiated agreements on the intellectual property rights for pharmaceuticals. In its current form, Thailand's NAPHA program is affordable. Under the model's assumptions, it is also cost-effective relative to the baseline scenario. Furthermore, although the two enhanced policies we suggest early recruitment through expanded voluntary counseling and testing (VCT) and improved adherence through Person living with HIV/AIDS (PHA) groups are less cost-effective, they are still a good bargain, particularly if both are enacted.


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    Revenga, Ana, Over, Mead, Masaki, Emiko, Peerapatanapokin, Wiwat, Gold, Julian, Tangcharoensathien, Viroj, Thanprasertsuk, Sombat

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    East Asia and Pacific,

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    The economics of effective AIDS treatment : evaluating policy options for Thailand

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    Acquired immunodeficiency syndrome, AIDS Committee, AIDS Deaths, AIDS Epidemic, AIDS patients, AIDS spending, AIDS Treatment, Behavioral Change, Behavioral Surveillance, Blood Donors, cancer, case of AIDS, Cell Count, clinics, Commercial Sex, Commercial Sex Workers, complications, Comprehensive Care, Condom, condom distribution, Condom Use, Condoms, consistent use of condoms, Cost Effectiveness, developing countries, diagnostic tests, Discrimination, Disease, diseases, dissemination, District Hospital, dose combination, Drug Regimens, drug user, Drugs, Epidemiology, extramarital sex, female sex partners, female sex workers, Global AIDS Program, government agencies, HEALTH, health care, Health Insurance, Health Policy, health sector, health system, heart disease, high-risk, high-risk behavior, high-risk groups, HIV, HIV infected people, HIV Infections, HIV prevention, HIV testing, HIV transmission, HIV-Positive People, Hospital, Hospitals, Household Income, human development, Human immunodeficiency virus, illness, immune systems, immunodeficiency, Impact on health, Insurance Schemes, intervention, intravenous drug users, lab tests, large numbers of people, legal status, longevity, Malaria, male sex, Medical Care, medical services, meningitis, Mode of Transmission, mother, mother-to-child, National AIDS, National AIDS Prevention, national resources, Needle sharing, New AIDS Cases, new cases, new infections, Nucleoside reverse, number of people, NUTRITION, opportunistic illnesses, Opportunistic infection, opportunistic infections, outpatient department, Patient, Patient Choice, People Living with AIDS, pneumonia, policy makers, Pregnant Women, Prevalence, prevalence rate, prevalence rates, prevention activities, Prevention Efforts, Prevention of mother, Prevention of mother-to-child transmission, Protease inhibitor, protease inhibitors, Public Health, Public Hospitals, Public policy, resistant strains, Risk Behavior, risk behaviors, risk of transmission, risky behaviors, Second-line regimens, service delivery, Service Providers, sex with men, Sex Workers, sexual contact, sexual relationships, Sexually Transmitted Infections, Social Development, Social Security, spillover, T-cell, Therapy, Transmission, triple-drug combination, Tuberculosis, UNAIDS, viral loads, Voluntary Counseling, World Health Organization, Youth



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Revenga, Ana Over, Mead Masaki, Emiko Peerapatanapokin, Wiwat Gold, Julian Tangcharoensathien, Viroj Thanprasertsuk, Sombat

The economics of effective AIDS treatment : evaluating policy options for Thailand (Thai). Health, nutrition, and population series Washington, D.C. : World Bank Group.