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Estimating the Health Insurance Liability for Treatment of HIV/AIDS in Vietnam (2016-2020)

This study estimates the national health insurance liability for HIV/AIDS treatment in Vietnam and provides recommendations for sustaining funding. Results show the projected liability and costs for treatment over the period, highlighting the need for alternative solutions.

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Estimating the Health Insurance Liability for Treatment of HIV/AIDS in Vietnam (2016-2020)

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  1. Estimating the Health Insurance Liability for Treatment of HIV/AIDS in Vietnam (2016-2020) Naz Todini, Benjamin Johns, Kieu Huu Hanh, Nguyen Thuy Huong, Duong Thuy Anh, Nguyen Hoang Long USAID/Health Financing Governance Project

  2. Outline Background Objectives Methods Results Conclusions Recommendations

  3. Introduction Vietnam’s HIV/AIDS response is mainly financed by external sources, with 73% of spending on HIV funded by international donors for the period 2008-2010. As donor funding is expected to decline over the coming years, it is critical for the Government of Vietnam (GVN) to identify viable solutions for sustaining HIV/AIDS activities.

  4. Introduction • The Decision No 1899/QD-TTg has identified funding HIV/AIDS services through SHI as one of the key strategies to ensure long term sustainability of HIV/AIDS treatment services. • The Model to Estimate HI Liability for Treatment of HIV/AIDS in Vietnam provides financial forecasts on the amounts of funding needed from SHI and other sources for HIV/AIDS treatment.

  5. Objectives • Estimate the liability of the national health insurance scheme for supporting the treatment of people living with HIV/AIDS. • Establish a methodology that can be adapted in the future as more data become available. • Recommend package of HIV/AIDS treatment services to be paid through VSS SHI

  6. Methodology In order to estimate the future liability and costs for the treatment of HIV/AIDS, a deterministic model was developed in Microsoft Excel. Liability is calculated using the following formula: [People in need of services x accessing rate x insurance coverage] x [number of services x price of service] x [1 – patient copayment rate]

  7. Methodology

  8. Results – hi liability for hiv treatment

  9. Basic packages for HIV/AIDS care and treatment should be paid by HI

  10. Projected number of people seeking HIV treatment enrolled in HI

  11. Estimated insurance liability for treatment of HIV/AIDS (Billion dong)

  12. Insurance liability for treatment of each patient

  13. Range of projected liability based on sensitivity analyses

  14. Results – Total resource needed

  15. Projected number of people seeking HIV treatment

  16. Estimated total costs of HIV treatment (VND billions)

  17. Who will pay? (average across 2016 to 2020)

  18. Conclusions The insurance liability for HIV/AIDS treatment would be about VND 138 billion in 2015, rising to VND 802 billion in 2020. Based on sensitivity analyses, liability in 2020 could be as high as VND1000 billion, The base case results presented for 2020 represent 1.2% of total SHI expenditures in 2014. Our model’s maximum liability projections for 2020 represent 2.4% of total SHI expenditures in 2014.

  19. Conclusion Based on 2014 SHI expenditure data, the difference between high and low scenarios we presented represent less than 1.0% of SHI expenditures. HIV/AIDS treatment liability per person is about 5.6 times overall SHI expenditures per person. In setting with higher HIV prevalence, such wide variations will have much larger implications for national health insurance

  20. Recommendations We recommend that VSS include HIV/AIDS as a module in its overall actuarial projection models, and continue to refine and update their liability associated with HIV/AIDS. Liability potentially most affected by price of ARVs; high price procurement of ARVs has most potential to increase HI liability. Solutions to reduce the price of ARV are needed.

  21. Thank you

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