Willingness to pay for antiretroviral drugs among HIV and AIDS clients in south-east Nigeria

Health Expect. 2018 Feb;21(1):270-278. doi: 10.1111/hex.12612. Epub 2017 Aug 14.


Background: The current trend of withdrawal of donor support for HIV/AIDS treatment in Nigeria may require that the cost of antiretroviral drugs be borne in part by infected people and their families.

Objective: This study was conducted to determine the economic value for free antiretroviral drugs (ARVs) expressed by clients receiving treatment for HIV/AIDS in a tertiary hospital.

Study method: The contingent valuation method was used to elicit the values attached to free ARVs from people living with HIV/AIDS that were receiving care in a public tertiary hospital in south-east Nigeria. Exit poll using a pre-tested questionnaire was undertaken with adult clients on treatment. The bidding game technique was used to elicit their willingness to pay (WTP) for ARVs for themselves and members of their households. Ordinary least squares (OLS) multiple regression analysis was used to test the construct validity of elicited WTP amounts.

Results: About a third of the respondents were willing to pay for a monthly supply of ARVs for themselves and household members. The mean WTP for monthly supply of ARVs for self was US$15.32 and for household member was US$15.26 (1US$=₦160). OLS regression analysis showed that employment status and higher socio-economic status were positively associated with higher WTP. OLS showed that age and transport cost per clinic visit were negatively related to WTP. Knowing the risks of not adhering to treatment protocol was positively related to WTP.

Conclusion: The respondents positively valued the free ARVs. This calls for greater financial support for the sustainable provision of the treatment service. However, holistic financing mechanisms should be explored to ensure sustained funding in the event of complete withdrawal of donor support.

Keywords: HIV and AIDS; antiretroviral drugs; clients; willingness to pay.

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy*
  • Acquired Immunodeficiency Syndrome / economics
  • Adult
  • Anti-Retroviral Agents / economics
  • Anti-Retroviral Agents / therapeutic use*
  • Attitude to Health*
  • Female
  • Financing, Personal*
  • Humans
  • Male
  • Nigeria
  • Social Class
  • Surveys and Questionnaires


  • Anti-Retroviral Agents