IDEAS home Printed from
   My bibliography  Save this article

Unit Costs for Delivery of Antiretroviral Treatment and Prevention of Mother-to-Child Transmission of HIV


  • Omar Galárraga
  • Veronika Wirtz
  • Alejandro Figueroa-Lara
  • Yared Santa-Ana-Tellez
  • Ibrahima Coulibaly
  • Kirsi Viisainen
  • Antonieta Medina-Lara
  • Eline Korenromp


As antiretroviral treatment (ART) for HIV/AIDS is scaled up globally, information on per-person costs is critical to improve efficiency in service delivery and to maximize coverage and health impact. The objective of this study was to review studies on unit costs for delivery of adult and paediatric ART per patient-year, and prevention of mother-to-child transmission (PMTCT) interventions per mother-infant pair screened or treated, in lowand middle-income countries. A systematic review was conducted of English, French and Spanish publications from 2001 to 2009, reporting empirical costing that accounted for at least antiretroviral (ARV) medicines, laboratory testing and personnel. Expenditures were analysed by country-income level and cost component. All costs were standardized to $US, year 2009 values. Several sensitivity analyses were conducted. Analyses covered 29 eligible, comprehensive, costing studies. In the base case, in low-income countries (LIC), median ART cost per patient-year was $US792 (mean: 839, range: 682–1089); for lower-middle-income countries (LMIC), the median was $US932 (mean: 1246, range: 156–3904); and, for upper-middle-income countries (UMIC), the median was $US1454 (mean: 2783, range: 1230–5667). ARV drugs were the largest component of overall ART costs in all settings (64%, 50% and 47% in LIC, LMIC and UMIC, respectively). Of 26 ART studies, 14 reported the drug regimes used, and only one study explicitly reported second-line treatment costs. The second cost driver was laboratory cost in LIC and LMIC (14% and 20%), and personnel costs in UMIC (26%). Two ART studies specified the types of laboratory tests costed, and three studies specifically included above facility-level personnel costs. Three studies reported detailed PMTCT costs, and three studies reported on paediatric ART. There is a paucity of data on the full unit costs for delivery of ART and PMTCT, particularly for LIC and middle-income countries. Heterogeneity in activities costed, and insufficient detail regarding components included in the costing, hampers standardization of unit cost measures. Evaluation of programme-level unit costs would benefit frominternational guidance on standardized costing methods, and expenditure categories and definitions. Future work should help elucidate the sources of the large variations in delivery unit costs across settings with similar income and epidemiological characteristics. Copyright Springer International Publishing AG 2011

Suggested Citation

  • Omar Galárraga & Veronika Wirtz & Alejandro Figueroa-Lara & Yared Santa-Ana-Tellez & Ibrahima Coulibaly & Kirsi Viisainen & Antonieta Medina-Lara & Eline Korenromp, 2011. "Unit Costs for Delivery of Antiretroviral Treatment and Prevention of Mother-to-Child Transmission of HIV," PharmacoEconomics, Springer, vol. 29(7), pages 579-599, July.
  • Handle: RePEc:spr:pharme:v:29:y:2011:i:7:p:579-599
    DOI: 10.2165/11586120-000000000-00000

    Download full text from publisher

    File URL:
    Download Restriction: Access to full text is restricted to subscribers.

    File URL:
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Markus Haacker & Mariam Claeson, 2009. "HIV and AIDS in South Asia : An Economic Development Risk," World Bank Publications - Books, The World Bank Group, number 2598, December.
    2. S. Mahendra Dev, 2008. "India," Chapters, in: Anis Chowdhury & Wahiduddin Mahmud (ed.), Handbook on the South Asian Economies, chapter 1, Edward Elgar Publishing.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Sterck, Olivier, 2016. "Natural resources and the spread of HIV/AIDS: Curse or blessing?," Social Science & Medicine, Elsevier, vol. 150(C), pages 271-278.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Goodness C. Aye & Stephen M. Miller & Rangan Gupta & Mehmet Balcilar, 2016. "Forecasting US real private residential fixed investment using a large number of predictors," Empirical Economics, Springer, vol. 51(4), pages 1557-1580, December.
    2. Gamboa, Luis Fernando & Otero, Jesús, 0. "An estimation of the pattern of diffusion of mobile phones: The case of Colombia," Telecommunications Policy, Elsevier, vol. 33(10-11), pages 611-620, November.
    3. Abdulla S. Al-Khulaifi, 2013. "Exports and Imports in Qatar: Evidence from Cointegration and Error Correction Model," Asian Economic and Financial Review, Asian Economic and Social Society, vol. 3(9), pages 1122-1133, September.
    4. Carmody, Pádraig, 2009. "An Asian-Driven Economic Recovery in Africa? The Zambian Case," World Development, Elsevier, vol. 37(7), pages 1197-1207, July.
    5. Ejaz Ghani & Arti Grover Goswami & William R. Kerr, 2016. "Highway to Success: The Impact of the Golden Quadrilateral Project for the Location and Performance of Indian Manufacturing," Economic Journal, Royal Economic Society, vol. 126(591), pages 317-357, March.
    6. Jorge Puig, 2014. "Multiplicador del gasto público en Argentina," Económica, Departamento de Economía, Facultad de Ciencias Económicas, Universidad Nacional de La Plata, vol. 60, pages 188-210, January-D.
    7. Pradhan, Jaya Prakash, 2005. "Different Shades of American Protectionism," MPRA Paper 16004, University Library of Munich, Germany.
    8. Deakin, Simon & Sarkar, Prabirjit & Singh, Ajit, 2010. "An End to Consensus? The (Non) Impact of Legal Reforms on Financial Development," MPRA Paper 53352, University Library of Munich, Germany.
    9. Ravallion, Martin, 2010. "The Developing World's Bulging (but Vulnerable) Middle Class," World Development, Elsevier, vol. 38(4), pages 445-454, April.
    10. Lakatos, Csilla & Fukui, Tani, 2014. "The Liberalization of Retail Services in India," World Development, Elsevier, vol. 59(C), pages 327-340.
    11. David Brady & Michael Spence, 2010. "Leadership and Growth : Commission on Growth and Development," World Bank Publications - Books, The World Bank Group, number 2404, December.
    12. Crow, Ben & Singh, Nirvikar, 2009. "The Management of International Rivers as Demands Grow and Supplies Tighten: India, China, Nepal, Pakistan, Bangladesh," Santa Cruz Department of Economics, Working Paper Series qt48n485pc, Department of Economics, UC Santa Cruz.
    13. Toru Tachibana, 2015. "Inundation behavior of the 2011 Tohoku earthquake tsunami in the Taro District, Miyako City, northeast Japan, as inferred from directional traces," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 75(3), pages 2311-2330, February.
    14. James B. Davies & Susanna Sandström & Anthony Shorrocks & Edward N. Wolff, 2011. "The Level and Distribution of Global Household Wealth," Economic Journal, Royal Economic Society, vol. 121(551), pages 223-254, March.
    15. Annafari, Mohammad Tsani, 2013. "Multiple subscriptions of mobile telephony: Explaining the diffusion pattern using sampling data," Telecommunications Policy, Elsevier, vol. 37(10), pages 930-939.
    16. Ghosh, Saibal, 2009. "Productivity and Financial Structure: Evidence from Indian High-Tech Firms," MPRA Paper 19467, University Library of Munich, Germany.
    17. Ilke Onur & Malathi Velamuri, 2016. "A Life Course Perspective on Gender Differences in Cognitive Functioning in India," Journal of Human Capital, University of Chicago Press, vol. 10(4), pages 520-563.
    18. Yamauchi, Futoshi & Higuchi, Katsuhiko & Suhaeti, Rita Nur, 2009. "Impacts of prenatal and environmental factors on child growth: Evidence from Indonesia," IFPRI discussion papers 933, International Food Policy Research Institute (IFPRI).
    19. Chandan Sharma & Sanjay Sehgal, 2010. "Impact of infrastructure on output, productivity and efficiency," Indian Growth and Development Review, Emerald Group Publishing Limited, vol. 3(2), pages 100-121, September.
    20. Temper, Leah & Martinez-Alier, Joan, 2013. "The god of the mountain and Godavarman: Net Present Value, indigenous territorial rights and sacredness in a bauxite mining conflict in India," Ecological Economics, Elsevier, vol. 96(C), pages 79-87.

    More about this item


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:29:y:2011:i:7:p:579-599. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.