Short-term cost and efficiency analysis of raltegravir versus atazanavir/ritonavir or darunavir/ritonavir for treatment-naive adults with HIV-1 infection in Spain
| Autor: | Gonzalo Nocea, Ashley E. Davis, Anita Brogan, Bridgett Goodwin, Virginia Lozano |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology medicine.medical_specialty Darunavir+Ritonavir Drug-Related Side Effects and Adverse Reactions Anti-HIV Agents 030106 microbiology Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Cohort Studies 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Antiretroviral Therapy Highly Active Internal medicine medicine Humans Pharmacology (medical) 030212 general & internal medicine Darunavir business.industry medicine.disease Raltegravir Atazanavir Clinical trial Treatment Outcome Infectious Diseases Spain Costs and Cost Analysis Female Ritonavir business medicine.drug |
| Zdroj: | HIV Clinical Trials. 18:214-222 |
| ISSN: | 1945-5771 1528-4336 |
| DOI: | 10.1080/15284336.2017.1402144 |
| Popis: | The AIDS Clinical Trial Group (ACTG) 5257 clinical trial showed that raltegravir (RAL) was superior to atazanavir/ritonavir (ATV/r) and darunavir/ritonavir (DRV/r), when used in combination with emtricitabine/tenofovir DF (FTC/TDF), in a 96-week composite endpoint combining virologic efficacy and tolerability for treatment-naive adults with HIV-1 infection. This study aimed to estimate the efficiency associated with these three regimens in Spain.An economic model was developed to estimate costs for antiretroviral drugs, adverse event management, and HIV care for individuals initiating first-line therapy. Antiretroviral drug costs were based on hospital costs with mandatory discounts applied. Adverse event management costs and HIV care costs were obtained from published sources and inflated to 2015 euros. Head-to-head efficacy and safety data (discontinuation rates, mean CD4 cell-count changes, adverse event incidence) up to 96 weeks for each regimen were obtained from the clinical trial. The efficiency of each regimen, as measured by the cost per successfully treated patient (i.e. on first-line therapy for 96 weeks), was estimated and examined in sensitivity analyses. All cost outcomes were discounted at 3.0% annually.Total costs per successfully treated patient were €22,377 for RAL, €26,629 for ATV/r, and €23,928 for DRV/r. These results were found to be robust in sensitivity analyses.RAL has the lowest cost per successfully treated patient when compared with DRV/r and ATV/r, each used in combination with FTC/TDF, for treatment-naive adults with HIV-1 infection in Spain. This economic evidence complements the clinical benefits of RAL reported in the ACTG 5257 clinical trial. |
| Databáze: | OpenAIRE |
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