Analysis of costs and cost-effectiveness of preferred GESIDA/National AIDS Plan regimens for initial antiretroviral therapy in human immunodeficiency virus infected adult patients in 2013

Antonio Javier Blasco, Josep M. Llibre, José Ramón Arribas, Vicente Boix, Bonaventura Clotet, Pere Domingo, Juan González-García, Hernando Knobel, Juan Carlos López, Fernando Lozano, José M. Miró, Daniel Podzamczer, Juan Miguel Santamaría, Montserrat Tuset, Laura Zamora, Pablo Lázaro, Josep M. Gatell

Research output: Contribution to journalArticleResearchpeer-review

14 Citations (Scopus)

Abstract

Introduction The GESIDA and National AIDS Plan panel of experts have proposed "preferred regimens" of antiretroviral treatment (ART) as initial therapy in HIV infected patients for 2013. The objective of this study is to evaluate the costs and effectiveness of initiating treatment with these "preferred regimens". Methods An economic assessment of costs and effectiveness (cost/effectiveness) was performed using decision tree analysis models. Effectiveness was defined as the probability of having viral load < 50 copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regime was defined as the costs of ART and its consequences (adverse effects, changes of ART regime and drug resistance analyses) during the first 48 weeks. The perspective of the analysis is that of the National Health System was applied, only taking into account differential direct costs: ART (official prices), management of adverse effects, resistance studies, and determination of HLA B*5701. The setting is Spain and the costs are those of 2013. A sensitivity deterministic analysis was performed, constructing three scenarios for each regimen: baseline, most favourable, and most unfavourable cases. Results In the baseline case scenario, the cost of initiating treatment ranges from 6,747 euros for TDF/FTC + NVP to 12,059 euros for TDF/FTC + RAL. The effectiveness ranges between 0.66 for ABC/3TC + LPV/r and ABC/3TC + ATV/r, and 0.87 for TDF/FTC + RAL and ABC/3TC + RAL. Effectiveness, in terms of cost/effectiveness, varies between 8,396 euros and 13,930 euros per responder at 48 weeks, for TDF/FTC/RPV and TDF/FTC + RAL, respectively. Conclusions Taking ART at official prices, the most effective regimen was TDF/FTC/RPV, followed by the rest of non-nucleoside containing regimens. The sensitivity analysis confirms the robustness of these findings. © 2013 Elsevier España, S.L.
Original languageEnglish
Pages (from-to)568-578
JournalEnfermedades Infecciosas y Microbiologia Clinica
Volume31
Issue number9
DOIs
Publication statusPublished - 1 Nov 2013

Keywords

  • AIDS
  • Antiretrovirals
  • Cost
  • Effectiveness
  • Efficacy
  • Human immunodeficiency virus
  • Therapy

Fingerprint

Dive into the research topics of 'Analysis of costs and cost-effectiveness of preferred GESIDA/National AIDS Plan regimens for initial antiretroviral therapy in human immunodeficiency virus infected adult patients in 2013'. Together they form a unique fingerprint.

Cite this