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Costs of hospital-based methadone maintenance treatment in HIV/AIDS control among injecting drug users in Indonesia

Listed author(s):
  • Afriandi, Irvan
  • Siregar, Adiatma Y.M.
  • Meheus, Filip
  • Hidayat, Teddy
  • van der Ven, Andre
  • van Crevel, Reinout
  • Baltussen, Rob

Objective To assess the cost of hospital-based methadone maintenance treatment (MMT) for injecting drug users (IDUs) in Bandung, Indonesia; to address concerns of financial sustainability at the hospital level and financial accessibility and economic attractiveness at the health care policy level.Methods In a 1 year observation period in 2006-2007, MMT service delivery costs were estimated on the basis of a micro-costing approach. Patient costs were estimated on the basis of a survey among 48 methadone clients.Results A total number of 129 clients attended the MMT clinic, resulting in a total of 16,335 client visits. Total annual societal costs of running the MMT clinic equalled Rp 1130 mln (US$123,672), or Rp 69,206 (US$7.57) per client visit. Of total costs, patient costs established the largest share (65%), followed by that of central government (20%), and the hospital (15%). Present consultation tariffs already cover hospital costs and the patient costs of accessing MMT services constitute almost 70% of their income.Conclusion Under current circumstances, MMT services are financially sustainable to the hospital. MMT services are subsidized by the central government, and this is warranted considering the important role of the program in HIV/AIDS among IDUs. Still, the present user fee seems a barrier to utilization, and a higher level of subsidy might be justified to reduce the cost to the patient.

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File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(09)00288-7
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Article provided by Elsevier in its journal Health Policy.

Volume (Year): 95 (2010)
Issue (Month): 1 (April)
Pages: 69-73

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Handle: RePEc:eee:hepoli:v:95:y:2010:i:1:p:69-73
Contact details of provider: Web page: http://www.elsevier.com/locate/healthpol

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  1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453, April.
  2. Ver Eecke, W., 1998. "The concept of a "merit good" the ethical dimension in economic theory and the history of economic thought or the transformation of economics into socio-economics," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 27(1), pages 133-153.
  3. Benjamin Johns & Rob Baltussen, 2004. "Accounting for the cost of scaling-up health interventions," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1117-1124.
  4. Jouni Paavola, 2009. "From market failure paradigm to an institutional theory of environmental governance," ECONOMICS AND POLICY OF ENERGY AND THE ENVIRONMENT, FrancoAngeli Editore, vol. 0(1), pages 87-101.
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