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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
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Cost considerations in the current antiretroviral era
Ellen F Eaton1, Ashutosh Tamhane, Michael Saag
1aDivision of Infectious Diseases, Department of Medicine bDepartment of Healthcare Organization and Policy, Ryals School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
AIDS (London, England)
|April 19, 2016
Summary
For HIV treatment, efavirenz and raltegravir regimens are the most cost-effective options for treatment-naïve patients. Rilpivirine may be suitable in specific situations, warranting further research.
Area of Science:
- Infectious Diseases
- Pharmacoeconomics
- Public Health
Background:
- US national guidelines emphasize cost-conscious practices in healthcare, including antiretroviral therapy selection.
- Optimizing the cost-effectiveness of HIV treatment is crucial for sustainable patient care.
Purpose of the Study:
- To evaluate the relative cost-effectiveness of contemporary antiretroviral therapy (ART) regimens.
- To identify the most economically viable ART options for treatment-naïve individuals living with HIV.
Main Methods:
- Retrospective cohort study of 491 treatment-naïve HIV patients initiating ART between 2007-2012.
- Analysis of regimen durability using Kaplan-Meier survival analyses and cost data based on 30-day supply prices.
- Sensitivity analyses were conducted to assess the impact of missing data and pricing variations.
Main Results:
- Median regimen durability varied, with ritonavir-boosted darunavir and raltegravir lasting the longest (47.8 months).
- Efavirenz-based regimens ($710.64/month) and raltegravir-based regimens ($1075.03/month) demonstrated superior cost-effectiveness.
- Raltegravir offered additional therapy at an incremental cost of $47/month compared to efavirenz.
Conclusions:
- Efavirenz and raltegravir-based regimens are the most cost-effective choices for treatment-naïve HIV patients in this cohort.
- Rilpivirine-based regimens showed value in specific scenarios, while further data on efavirenz and rilpivirine comparative effectiveness is needed.
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