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Treatment outcome and cost-effectiveness of different highly active antiretroviral therapy regimens in the UK (1996-2002)
- Source :
- International journal of STDAIDS. 19(5)
- Publication Year :
- 2008
-
Abstract
- The aim of this study was to estimate the outcome and cost-effectiveness per life-year-gained (LYG) of first-, second- and third-line non-nucleoside reverse transcriptase inhibitors (NNRTI) versus protease inhibitor (PI) containing highly active antiretroviral therapy regimens. Hospital care costs (2002 US dollars discounted 3.5% per annum) were linked to treatment failure times. Results show that the median time-to-treatment failure for first-line (nucleoside reverse transcriptase inhibitors) 2NRTIs + NNRTI was substantially longer than that for 2NRTIs + PIboosted, 2NRTIs + PI and 2NRTIs + 2PIs, whereas for second- and third-line they were similar. Comparing first-line 2NRTIs + NNRTI with 2NRTIs + PIboosted cost per LYG was US$ 12,375; US$ 12,139 per LYG when compared with 2NRTIs + PI and US$ 2948 per LYG when compared with 2NRTIs + 2PIs. For second-line cost per LYG comparing 2NRTIs + NNRTI with 2NRTIs + PIboosted was US$ 19,501; US$ 18,364 per LYG when compared with 2NRTIs + PI and cost-saving when compared with 2NRTIs + 2PIs. For third-line cost per LYG comparing 2NRTIs + NNRTI with 2NRTIs + PIboosted was US$ 2708; US$ 11,559 per LYG when compared with 2NRTIs + PI and cost-saving when compared with 2NRTIs + 2PIs. In conclusion, first-line 2NRTIs + NNRTI was cost-effective or cost-saving when compared with PI-containing regimens for all lines of therapy. Such information is required by clinicians and managers of HIV services to make appropriate treatment decisions based on clinical and financial grounds, and given the increasing number of people living with HIV, such information will become more important over time.
- Subjects :
- Oncology
Sexually transmitted disease
Adult
Male
medicine.medical_specialty
Cost effectiveness
Anti-HIV Agents
Cost-Benefit Analysis
Treatment outcome
HIV Infections
Dermatology
Treatment failure
Nucleoside Reverse Transcriptase Inhibitor
Internal medicine
Antiretroviral Therapy, Highly Active
Medicine
Humans
Pharmacology (medical)
Royaume uni
business.industry
Public Health, Environmental and Occupational Health
Middle Aged
Virology
Antiretroviral therapy
Hospital care
Infectious Diseases
Treatment Outcome
England
Reverse Transcriptase Inhibitors
Female
business
Subjects
Details
- ISSN :
- 09564624
- Volume :
- 19
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- International journal of STDAIDS
- Accession number :
- edsair.doi.dedup.....03ad91e1615ce323978d16ca009a27fd