艾滋病抗病毒治疗单位成本核算分析
Unit cost of antiretroviral treatment of HIV /AIDS cases
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摘要: 目的核算中国不同地区艾滋病抗病毒治疗的单位成本,为今后艾滋病防治预算制定和资源分配提供经济学依据。方法采用自下而上法收集抗病毒治疗成本,根据患者抗病毒治疗流程,采取查阅现场资料和关键人物访谈方法收集艾滋病患者治疗前、治疗中以及治疗随访过程中的相关费用,测算各子成本并加和形成总的单位成本及其构成。结果根据抗病毒药物种类以及是否是新入组患者2个因素进行分层,在使用奈韦拉平(NVP)一线药物组合中,新入组患者抗病毒治疗单位成本中位数为5 907.46元/人年,既往入组患者为3 598.89元/人年;在使用依非韦伦(EFV)的一线药物组合中,新入组患者抗病毒治疗单位成本中位数为8 471.22元/人年,既往入组患者为6 162.65元/人年;在二线药物的组合中,新入组患者抗病毒治疗单位成本中位数为13 275.30元/人年,既往入组患者为10 966.73元/人年。抗病毒治疗单位成本的构成以药物成本和检测成本为主,二者合计占90%(91.33%97.15%)以上。结论对抗病毒治疗单位成本大小影响最大的因素是药物组合和检测是收费标准,交通成本也是抗病毒治疗成本变异的主要因素。Abstract: Objective To calculate the unit cost of antiretroviral treatment( ART) of HIV /AIDS cases and to provide data for scientific budget planning and resource allocation of HIV / AIDS prevention and control. Methods Bottomup method was used to collect the cost data of HIV / AIDS ART. The unit cost was split into various sub-additive ones. Field observation method and key informant interview were used to collect related data on the cost of ART and every subcost was measured to estimate unit cost and its composition. Results The unit cost was calculated according to classification of ART drug and whether the patient was a new enrollment or having previous treatment. In the group of first-line drugs and drug combinations using nevirapine,the median unit cost of a new enrolled ART patient and a previously enrolled patient were 5 907. 46 RMB yuan per year and 3 598. 89 yuan per year,respectively. In the group of first-line drugs and drug combinations using efavirenz,the median unit cost of a new enrolled ART patient and a previously enrolled patient were 8 471. 22 RMB yuan per year and 6 162. 65 RMB yuan per year,respectively. In the group of combination of second-line drugs,the median unit cost of a new enrolled ART patient and a previously enrolled patient were 13 275. 30 RMB yuan per year and 10 966. 73 RMB yuan per year,respectively. Drug cost and related test cost accounted for more than 90% of the unit cost of ART. Conclusion The main influencing factors of unit cost of ART are drug combinations and related test fees.