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Willingness to Pay for Health Insurance Among HIV-Positive Patients in India

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Abstract

Background

Standard health insurance products in India currently exclude conditions related to HIV. Although antiretroviral (ARV) drugs are now publicly funded, the burden of treatment due to hospitalization on people living with HIV and AIDS (PLHIV) continues to be high. Unlike many countries, India is yet to eliminate the exclusion clause in standard health insurance products.

Objective

The overall aim of this study was to understand if PLHIV would be willing to participate in and purchase commercial health insurance, if it were offered to them.

Methods

This study uses primary survey data to analyse the burden of treatment due to hospitalization and estimates the willingness to pay (WTP) for health insurance based on the contingent valuation approach.

Results

The average WTP per year was in the range of Indian rupee (R) 1,145–1,355 or $US20–24, with hospitalization and economic status significantly affecting the WTP.

Conclusion

The findings of the study can serve as evidence for possible changes to policy on health insurance that would allow PLHIV to purchase health insurance.

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Notes

  1. The permanent exclusion clause is for certain conditions that are excluded ‘forever’ from the list of benefits, irrespective of the time of its occurrence. These conditions largely represent either non-accidental losses (i.e. the occurrence of an event could be within the control of the claimant) or poorly defined losses (i.e. time, place and cause of a loss may not be clear).

  2. The term ‘diagnosed conditions’ was defined as diagnosis for hospitalization in the survey. Therefore, the reported response generally indicates the respondents’ perspective of the illness and may not align with exact clinical diagnosis. However, we attempted to classify these responses into medical categories using the ‘lay reporting of health information’ framework.

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Acknowledgments

The work was made possible through a grant of the US Agency for International Development (USAID) under the cooperative agreement 386-A-00-06-00145. The authors would like to gratefully acknowledge the entire team of the Population Services International-Connect programme and also Shalini Rudra for their input and help during the survey.

Conflict of interest

The authors declare that there are no conflicts of interest.

Author contributions

Professor Indrani Gupta takes overall responsibility for the entire research. She contributed to obtaining funding for research, conception and design of the research, analysis and interpretation, writing, as well as critical revision and final approval of the article.

Professor Mayur Trivedi contributed to conception and design of the research, analysis and interpretation, and writing and revision of the article.

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Authors and Affiliations

  1. Health Policy Research Unit, Institute of Economic Growth, Delhi University Enclave, Delhi, 110007, India

    Indrani Gupta

  2. Indian Institute of Public Health Gandhinagar, Ahmedabad, 380054, India

    Mayur Trivedi

Authors
  1. Indrani Gupta
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  2. Mayur Trivedi
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Corresponding author

Correspondence to Mayur Trivedi.

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Supplementary material 1 (DOCX 53 kb)

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Appendix : Equation for Regression

Appendix : Equation for Regression

Log (max WTP) = f(age, age squared, whether female, whether currently working, education up to primary, education up to secondary, whether currently married, duration on ART, number of household members HIV positive, economic status [in first quartile], economic status [in second quartile], economic status [in third quartile], whether hospitalized last year).

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Gupta, I., Trivedi, M. Willingness to Pay for Health Insurance Among HIV-Positive Patients in India. Appl Health Econ Health Policy 12, 601–610 (2014). https://doi.org/10.1007/s40258-014-0105-x

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