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HIV Drug Treatment Expenditures at the Instituto Mexicano del Seguro Social (IMSS)

HIV Drug Treatment Expenditures at the Instituto Mexicano del Seguro Social (IMSS). Cuernavaca Morelos, Mx. August 1 st , 2008. Background. Antiretrovirals (ARVs) are essential for individuals who live with HIV, but they are the most expensive component of HIV care.

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HIV Drug Treatment Expenditures at the Instituto Mexicano del Seguro Social (IMSS)

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  1. HIV Drug Treatment Expenditures at the Instituto Mexicano del Seguro Social (IMSS) Cuernavaca Morelos, Mx. August 1st, 2008.

  2. Background • Antiretrovirals (ARVs) are essential for individuals who live with HIV, but they are the most expensive component of HIV care. • After the Ministry of Health (SSA), the IMSS is the second most important provider of ARVs in Mexico, with about 18,000 patients under treatment in 2006. • Since 2001, the IMSS has had universal free access to ARVs; nevertheless, information about ARV costs is scarce.

  3. Objective To provide empirical evidence on: • Institutional Purchasing Prices. • Total Expenditures on ARVs. • Average Expenditures per IMSS beneficiary under treatment.

  4. Methodology Identification of ARV purchased and their providers (2002-2006) through the IMSS Purchasing Database The nominal prices were deflatedinto constant prices, using 2006 as the base year. Regression Model For predicting future data Calculation: ARVs Total Cost, Average Cost Per IMSS Beneficiary, per Therapeutic Group, and type of treatment First & Second Line (WHO)

  5. Results • The purchasing prices for 28 ARVs exhibit a declining trend: median reduction was 11.9%. • Most of ARVs were bought from distributors, or from indirect providers (not directly from the labs). • The main distributors were: • Fármacos Especializados • Selecciones Médicas • Ralca

  6. Data Source: IMSS

  7. Data Source: IMSS

  8. Data Source: IMSS

  9. Data Source: IMSS

  10. Conclusions • The purchasing prices show a lightly decreasing trend. • There is a rising trend in the total expenditure on ARV. • There is also a rising trend in the expenditure per IMSS beneficiary under ARV treatment. • Hypotheses: • Changes into second-line treatment • Shortage reductions / Advanced purchasing • This is one of the very few empirical works about this subject.

  11. Limitations • The reliability of the database. • Short time-series. • Estimated number of beneficiaries (CENSIDA´s Information). • Nevertheless, first analysis of the only public-access source.

  12. Comments andQuestions Rodrigo Medinilla rmedinilla@gmail.com, Omar Galárraga ogalarraga@insp.mx, Veronika Wirtz vwirtz@insp.mx.

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