ARV Treatment and Care for People Living with HIV: Cost-Benefit Analysis

OBJECTIVES: According to the latest statistics from the World Health Organization, more than 37.7 million people are living with HIV at the end of 2020 and about two thirds of those infected are in the African region and 680,000 people have died from HIV-related causes. HIV/AIDS is part of the list of serious or disabling illnesses requiring long-term care. According to the IHME, the death toll exceeds 860,000 and the disease burden estimated at more than 47 million years of life lost or DALYs.

METHODS: Aware of this problem, Morocco has made great strides in the fight against HIV-AIDS, thanks to the strong political will that has placed the response to HIV among the national health priorities. Since the introduction of ARVs in Morocco in 1998, the Ministry of Health and Social Protection has been providing free care for PLWHA, with additional support from the Global Fund. This has generated significant economic costs, making it an important public health issue. The aim of this study is to evaluate the return on investment of ARV treatment and total care for PLWHA.In this study, we sought to measure the cost-benefit ratio (CBR) of an investment to be made and the expected economic benefits.

RESULTS: The care package for PLWH includes antiretroviral treatment, drugs for certain opportunistic infections, HIV laboratory tests, immuno virological follow-up and consultation. The total cost of care for PLWHA amounts to US$ 5,246,387.23. We were able to identify the number of deaths prevented thanks to ARVs. The monetary value gained from the 1,098 deaths averted is US$70,225,363. The return on investment is 13.38.

CONCLUSIONS: This return on investment could be higher if we add the gains due to savings in social costs, as well as savings in indirect costs such as lost productivity due to absenteeism.