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Impact of the removal of patient co-payments for antiretroviral therapy (ART) on out-of-pocket expenditure, adherence and virological failure among Australian adults living with HIV

Author

Listed:
  • Evelyn, Lee
  • Limin, Mao
  • John, de Wit
  • John, Rule
  • Andrew, Carr
  • Krista J, Siefried

Abstract

: In 2015, New South Wales (Australia) removed patient co-payments for ART of HIV. We hypothesized the policy change would reduce overall out-of-pocket (OOP) healthcare expenditure, improve ART adherence, and better maintain HIV suppression. Methods: Using data from a national, 2-year prospective study of adults with HIV on ART (n=364) (2013-2017), we compared OOP healthcare expenditure, ART adherence, and virological failure (VF) in participants subject to the co-payment policy change with participants from other jurisdictions who never paid, and who always paid, co-payments. We used fixed effects regression models to compare outcomes, and incidence rates for VF.

Suggested Citation

  • Evelyn, Lee & Limin, Mao & John, de Wit & John, Rule & Andrew, Carr & Krista J, Siefried, 2021. "Impact of the removal of patient co-payments for antiretroviral therapy (ART) on out-of-pocket expenditure, adherence and virological failure among Australian adults living with HIV," Health Policy, Elsevier, vol. 125(9), pages 1131-1139.
    • Handle: RePEc:eee:hepoli:v:125:y:2021:i:9:p:1131-1139
    DOI: 10.1016/j.healthpol.2021.07.002
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    References listed on IDEAS

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    1. Knott, Rachel J. & Petrie, Dennis J. & Heeley, Emma L. & Chalmers, John P. & Clarke, Philip M., 2015. "The effects of reduced copayments on discontinuation and adherence failure to statin medication in Australia," Health Policy, Elsevier, vol. 119(5), pages 620-627.
    2. Hubert Barennes & Amphonexay Frichittavong & Marissa Gripenberg & Paulin Koffi, 2015. "Evidence of High Out of Pocket Spending for HIV Care Leading to Catastrophic Expenditure for Affected Patients in Lao People's Democratic Republic," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-20, September.
    3. Chun Yee Wong & Jessica Greene & Xenia Dolja‐Gore & Kees van Gool, 2017. "The Rise and Fall in Out‐of‐Pocket Costs in Australia: An Analysis of the Strengthening Medicare Reforms," Health Economics, John Wiley & Sons, Ltd., vol. 26(8), pages 962-979, August.
    4. Krista J Siefried & Limin Mao & Stephen Kerr & Lucette A Cysique & Thomas M Gates & John McAllister & Anthony Maynard & John de Wit & Andrew Carr & On behalf of PAART study investigators, 2017. "Socioeconomic factors explain suboptimal adherence to antiretroviral therapy among HIV-infected Australian adults with viral suppression," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-23, April.
    5. Carpenter, Anthony & Islam, M. Mofizul & Yen, Laurann & McRae, Ian, 2015. "Affordability of out-of-pocket health care expenses among older Australians," Health Policy, Elsevier, vol. 119(7), pages 907-914.
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