An economic case for providing free access to antiretroviral therapy for HIV-positive people in South Australia

Heymer, Kelly-Jean, Wentzlaff-Eggebert, Matthias, Mortimer, Elissa, & Wilson, David P. (2012) An economic case for providing free access to antiretroviral therapy for HIV-positive people in South Australia. Sexual Health, 9(3), pp. 220-226.

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As financial constraints can be a barrier to accessing HIV antiretroviral therapy (ART), we argue for the removal of copayment requirements from HIV medications in South Australia.


Using a simple mathematical model informed by available behavioural and biological data and reflecting the HIV epidemiology in South Australia, we calculated the expected number of new HIV transmissions caused by persons who are not currently on ART compared with transmissions for people on ART. The extra financial investment required to cover the copayments to prevent an HIV infection was compared with the treatment costs saved due to averting HIV infections.


It was estimated that one HIV infection is prevented per year for every 31.4 persons (median, 24.0–42.7 interquartile range (IQR)) who receive treatment. By considering the incremental change in costs and outcomes of a change in program from the current status quo, it would cost the health sector $17 860 per infection averted (median, $13 651–24 287 IQR) if ART is provided as a three-dose, three-drug combination without requirements for user-pay copayments.


The costs of removing copayment fees for ART are less than the costs of treating extra HIV infections that would result under current conditions. Removing the copayment requirement for HIV medication would be cost-effective from a governmental perspective.

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ID Code: 77920
Item Type: Journal Article
Refereed: Yes
DOI: 10.1071/SH10148
ISSN: 1448-5028
Divisions: Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Mathematical Sciences
Current > QUT Faculties and Divisions > Science & Engineering Faculty
Copyright Owner: Copyright 2012 CSIRO Publishing
Deposited On: 21 Oct 2014 22:28
Last Modified: 24 Oct 2014 02:51

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