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Economic evaluation of systemic treatments for cytomegalovirus retinitis in patients with AIDS.
- Source :
-
PharmacoEconomics [Pharmacoeconomics] 2001; Vol. 19 (5 Pt 2), pp. 535-50. - Publication Year :
- 2001
-
Abstract
- Objective: To determine the cost of using systemic therapy to treat newly diagnosed cytomegalovirus (CMV) retinitis in persons with AIDS.<br />Design: Incidence-based simulation model of CMV treatment from a government payer perspective.<br />Setting: Swiss healthcare system.<br />Patients and Participants: Patients with AIDS and newly diagnosed CMV retinitis.<br />Interventions: Patients were assigned to 1 of 4 treatment regimens for induction and maintenance therapy: (i) intravenous (IV) cidofovir induction and maintenance (cidofovir IV/IV); (ii) IV foscarnet induction and maintenance (foscarnet IV/IV); (iii) IV ganciclovir induction and maintenance (ganciclovir IV/IV); and (iv) IV ganciclovir induction and oral (PO) ganciclovir maintenance (ganciclovir IV/PO). Following a second relapse, patients were assigned to one of the other regimens.<br />Main Outcome Measures: Time to first and subsequent progression, duration of maintenance treatment and direct medical expenditures [1998 Swiss francs (SwF)] .<br />Results: The median time to first progression was longest for cidofovir IV/IV, followed by foscarnet IV/IV, ganciclovir IV/IV and ganciclovir IV/PO. Mean survival was 13 months and mean costs for this period in the base case were lowest in those initially treated with cidofovir (SwF146,742), followed by initial treatment with foscarnet IV/IV (SwF194,809), ganciclovir IV/PO (SwF195,190) and ganciclovir IV/IV (SwF243,964). Costs were most sensitive to changes in efficacy estimates.<br />Conclusions: Of the regimens studied, initiation of treatment with systemic cidofovir appears least costly over a 13-month period.
- Subjects :
- AIDS-Related Opportunistic Infections drug therapy
Adult
Antiviral Agents adverse effects
Antiviral Agents therapeutic use
Cidofovir
Cytomegalovirus Retinitis drug therapy
Cytosine adverse effects
Cytosine analogs & derivatives
Cytosine economics
Cytosine therapeutic use
Foscarnet adverse effects
Foscarnet economics
Foscarnet therapeutic use
Ganciclovir adverse effects
Ganciclovir economics
Ganciclovir therapeutic use
Humans
Organophosphorus Compounds adverse effects
Organophosphorus Compounds economics
Organophosphorus Compounds therapeutic use
Switzerland
Treatment Failure
AIDS-Related Opportunistic Infections economics
Antiviral Agents economics
Cytomegalovirus Retinitis economics
Economics, Pharmaceutical
Models, Economic
Organophosphonates
Subjects
Details
- Language :
- English
- ISSN :
- 1170-7690
- Volume :
- 19
- Issue :
- 5 Pt 2
- Database :
- MEDLINE
- Journal :
- PharmacoEconomics
- Publication Type :
- Academic Journal
- Accession number :
- 11465299
- Full Text :
- https://doi.org/10.2165/00019053-200119050-00008