治疗艾滋病毒的长期影响和价值:模型分析
Gregory F Guzauskas1,2, Timothy B Hallett3
1The Comparative Health Outcomes, Policy, and Economics Institute, Department of Pharmacy, University of Washington, Seattle, Washington, USA.
Journal of the International AIDS Society
|September 25, 2023
概括
与单独的抗逆转录病毒疗法 (ART) 相比,针对艾滋病毒的治愈疗法 (CTx) 可以显著改善健康结果并降低长期成本. 基于价值的CTx价格因国家而异,受艾滋病毒流行率,ART覆盖率和治愈概率的影响.
科学领域:
- 卫生经济学 卫生经济学
- 传染病建模 传染病建模
- 艾滋病毒/艾滋病研究研究
背景情况:
- 正在探索治愈疗法 (CTx),以实现艾滋病毒的持续缓解,而无需终身抗逆转录病毒疗法 (ART).
- 对艾滋病毒的长期健康和经济结果进行建模对于评估新的干预措施至关重要.
- 了解CTx的基于价值的特定国家价格 (VBPs) 对于资源分配至关重要.
研究的目的:
- 模拟不同国家的艾滋病毒的长期健康和成本结果.
- 评估假设未来CTx对这些结果的影响.
- 为了确定CTx的特定国家VBPs.
主要方法:
- 开发了一个决策分析模型来比较CTx+ART与单独的ART.
- 模拟了七个低收入和中等收入国家以及五个高收入国家的人口.
- 通过使用根据残疾调整的寿命年 (DALYs) 来量化健康结果,预计到2100.
主要成果:
- CTx的引入降低了艾滋病毒的流行率,预防了新的感染,并减少了与艾滋病相关的死亡和DALYs.
- 对CTx的基准案例VBPs在5,400美元 (肯尼亚) 到812,300美元 (美国) 之间.
- 在ART覆盖率较低,HIV发病率/流行率较低,CTx治愈概率较高的国家,VBP更高.
结论:
- 结果量化了未来在全球不同环境中治疗艾滋病毒的VBPs.
- 更高的CTx治疗概率,耐久性和扩展增加VBP;改进的ART覆盖可能会减少它.
- 建模框架可以在各种流行病和治疗场景下估计CTx的成本效益.
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