Cost estimates of HIV care and treatment with and without anti-retroviral therapy at Arba Minch Hospital in southern Ethiopia

To estimate the average per person year (PPY) cost of care for HIV patients with and without anti-retroviral therapy (ART) in a district hospital.Data on costs and utilization of HIV-related services were taken from Arba Minch Hospital (AMH) in southern Ethiopia. Mean annual outpatient and inpatient costs and corresponding 95% confidence intervals (CI) were calculated. We adopted a district hospital perspective and focused on hospital costs.PPY average (95% CI) costs under ART were US$235.44 (US$218.11–252.78) and US$29.44 (US$24.30–34.58) for outpatient and inpatient care, respectively. Estimates for the non-ART condition were US$38.12 (US$34.36–41.88) and US$80.88 (US$63.66–98.11) for outpatient and inpatient care, respectively. The major cost driver under the ART scheme was cost of ART drugs, whereas it was inpatient care and treatment in the non-ART scheme.The cost profile of ART at a district hospital level may be useful in the planning and budgeting of implementing ART programs in Ethiopia. Further studies that focus on patient costs are warranted to capture all patterns of service use and relevant costs. Economic evaluations combining cost estimates with clinical outcomes would be useful for ranking of ART services.The prevalence of HIV in adults in Ethiopia is 2.1% according to 2007 estimates [1]. About 242,548 adults living with HIV/AIDS require anti-retroviral therapy (ART) [1]. Ethiopia launched a nationwide ART program in January 2005 [2] with a policy to implement treatment to rural settings through peripheral healthcare facilities. The number of treatment sites had reached 272 by June 2007 [1]. Treatment coverage is about 35% [1], and the unmet need for ART in Ethiopia remains considerable.ART provision in Ethiopia is funded mainly through external programs such as the Global Fund to Fight AIDS, Tuberculosis and Malaria; the United States President's Emergency Plan For AIDS Relief; and other donor agencies. External funding may not continue at its curr