How expensive is availing free antiretroviral therapy services for HIV/AIDS patients in India ?

What is it about?

Since antiretroviral therapy in India is free, one expects that the out-of-pocket (OOP) expenditure would reduce and would not be a significant financial burden. However, the cost of seeking care is also dependent on accessibility of services, as well as other non-medical and indirect expenses. We measure the different expenses and their determinants.

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Why is it important?

1. Availing ‘free ART services’ in India is catastrophic in 8.1% and impoverishing in 43% of the households. This affects disease severity as well and jeopardizes the main objective of the program. 2. Since HIV/AIDS care is through a vertical program, we find that expenditures for financing health services are not the only cause of financial catastrophe. 3. As distance is a huge determinant of expenses, a service-level integration of HIV/AIDS care within UHC could solve a atleast 4 critical issues apart from reducing out of pocket expenditure and associated disease severity: 1. Ensure sustainable commitment to the program in the wake of reduced external funding, 2. HIV care integration with other services leads to successful outcomes as ‘people get the care they need, when they need it in user-friendly ways’, 3. Such integration provides a financial protection that goes beyond the narrow indicator of UHC-SDG's monitoring of spending in health service use alone, improving efficiency and equity of HIV/AIDS care 4. Improves local ownership and accountability reducing stigma and discrimination.

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