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Comparative cost-efficacy analysis of darunavir/ritonavir and other ritonavir-boosted protease inhibitors for first-line treatment of HIV-1 infection in the United States
- Source :
- HIV clinical trials. 11(3)
- Publication Year :
- 2010
-
Abstract
- A comprehensive study comparing the costs and efficacies of darunavir/ritonavir 800/100 mg qd and the other ritonavir-boosted (/r) protease inhibitors (PIs) recommended for treatment-naïve individuals with HIV-1 infection would help health care decision makers identify the value of each boosted PI.A cost-efficacy model was developed to compare the five recommended boosted PIs, each used with a tenofovir-based nucleotide/nucleoside reverse transcriptase inhibitor backbone. Efficacy was measured by virologic response (ie, HIV-1 ribonucleic acid50 copies/mL) at 48 weeks, based on a systematic review and meta-analysis of recent clinical trials. One-year antiretroviral therapy costs and 48-week efficacy values were used to generate the efficiency frontier and cost-efficacy ratios.Darunavir/r was the most efficacious boosted PI, with an incremental cost-efficacy ratio of $27,390 per additional individual with virologic response, compared with fosamprenavir/r. All other regimens were dominated. Darunavir/r combination therapy also had one of the lowest average costs ($26,287) per individual with virologic response, resulting in a maximal number of individuals successfully treated within a fixed budget. The model results were robust in variability and sensitivity analyses.Darunavir/r 800/100 mg qd combination therapy represents a cost-efficacious option for treatment-naïve individuals with HIV-1 infection in the United States.
- Subjects :
- Adult
Male
Endpoint Determination
medicine.medical_treatment
Cost-Benefit Analysis
Human immunodeficiency virus (HIV)
Fosamprenavir
HIV Infections
medicine.disease_cause
Nucleoside Reverse Transcriptase Inhibitor
Antiretroviral Therapy, Highly Active
medicine
Humans
Pharmacology (medical)
Darunavir
Sulfonamides
Protease
Ritonavir
business.industry
virus diseases
Cost efficacy
HIV Protease Inhibitors
Virology
United States
Clinical trial
Infectious Diseases
Treatment Outcome
HIV-1
RNA, Viral
Female
business
Models, Econometric
medicine.drug
Subjects
Details
- ISSN :
- 15284336
- Volume :
- 11
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- HIV clinical trials
- Accession number :
- edsair.doi.dedup.....dffc9d72efbcffbde2288bf5a7640022