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Updated: Mar 29, 2026

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
Cost-effectiveness of CYP2B6 genotyping to optimize efavirenz dosing in HIV clinical practice
Bruce R Schackman1, David W Haas2, Sanghee S Park3
1Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, NY, USA.
Aims:
To assess the cost-effectiveness of CYP2B6 genotyping to guide efavirenz dosing for initial HIV therapy in the USA.
Methods:
We used the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) microsimulation model to project quality-adjusted life expectancy and lifetime costs (2014 US dollars) for efavirenz-based HIV therapy with or without CYP2B6 genotyping. We assumed that with genotyping 60% of patients would be eligible to receive lower doses.
Results:
Current care without CYP2B6 genotyping has an incremental cost-effectiveness ratio >$100,000/QALY compared with genotype-guided dosing, even if lower dosing reduces efficacy. When we assumed generic efavirenz availability, conclusions were similar unless lower dosing reduces efficacy by 6% or more.
Conclusion:
CYP2B6 genotyping can inform efavirenz dosing and decrease HIV therapy cost.
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