Estimation of premium cost for HIV/AIDS patients under ART
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ORIGINAL ARTICLE
Estimation of premium cost for HIV/AIDS patients under ART Gurprit Grover1,2 • *Parmeet Kumar Vinit1,2 • V. K. Sehgal1,2
Received: 23 January 2020 / Revised: 26 July 2020 Ó The Society for Reliability Engineering, Quality and Operations Management (SREQOM), India and The Division of Operation and Maintenance, Lulea University of Technology, Sweden 2020
Abstract The primary aim of this paper is to bring an insurance plan for HIV/AIDS patients. Recent studies based on antiretroviral therapy (ART) and highly active antiretroviral therapy (HAART) suggests long term survival of HIV/AIDS patients. Use of cure fraction model has revealed that a considerable proportion of patients are long term survivors out of the diseased cohort (Grover et al. 2019). The survival time is defined under the purview of CD4 cell counts which are considered to be the disease marker for HIV/AIDS patients. Many patients suffer financially along with risk of death. Here, we introduce an insurance plan which involves low risk for insurers and affordable premium for patients. The premium is calculated, using the survival estimates from Kaplan–Meier survival curve, on the basis of a deterministic model. Keywords HIV/AIDS CD4 Kaplan–Meier Premium
1 Introduction HIV stands for Human Immuno-deficiency Virus. HIV destroys the immune system of the human body slowly and decreases its ability to fight from infections and diseases. The next stage of HIV infection is AIDS (Acquired Immune Deficiency Syndrome). At this stage, the immune system of the body becomes very weak and a group of & *Parmeet Kumar Vinit [email protected] 1
Department of Statistics, University of Delhi, Delhi 110007, India
2
Bundelkhand University, Jhansi 284128, India
symptoms appear. People infected with HIV can spend several productive years without showing any symptoms. HIV infected people might take around 8 to 10 years to reach the stage of AIDS from the time of HIV infection. National AIDS Control Organisation (NACO) steers HIV/ AIDS prevention, treatment, education, sensitization and control programmes in India. In India, HIV infection was detected in 1986 for the first time. It was detected in Chennai among the female sex workers. Currently the estimated number of infections is 5.134 million worldwide and India being home to the second largest population of people living with HIV/AIDS. Based on WHO criteria, highly active antiretroviral therapy (HAART) was given to the patient with absolute CD4 count \ 200 per microliter, having AIDS defining illness or CD4 count 200–300 with opportunistic infections. WHO staging of disease, was used to initiate HAART, before the introduction of CD4 counts. However, it is restricted to the patients from rural areas to initiate HAART due to unavailability of CD4 count (Solomon et al. 2006). As per WHO, the stages of HIV/AIDS on the basis of CD4 count (Syndrome 1990; Badri et al. 2001; World Health Organization 2005), are presented below in Table 1. Over the past decade deaths due to HIV/AIDS have declined po
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