杜鲁特格拉维尔
替诺福韦-阿拉芬酰胺
恩曲他滨
医学
埃法维伦兹
养生
成本效益
人类免疫缺陷病毒(HIV)
临床试验
病毒载量
抗逆转录病毒疗法
内科学
病毒学
风险分析(工程)
作者
Lise Jamieson,Celicia Serenata,Lebogang Makhubele,Simiso Sokhela,Nkuli Mashabane,Godspower Akpomiemie,Johnson Lf,W D Francois Venter,Gesine Meyer-Rath
出处
期刊:AIDS
[Ovid Technologies (Wolters Kluwer)]
日期:2021-12-15
卷期号:35 (Supplement 2): S173-S182
被引量:3
标识
DOI:10.1097/qad.0000000000003068
摘要
HIV programmes world-wide currently make decisions regarding new antiretroviral therapy (ART) regimens with less side-effects and higher resistance barriers, which may improve adherence and viral suppression. Economic evaluation helps inform these decisions.We conducted an economic evaluation of three ART regimens included in the ADVANCE trial from the provider's perspective: tenofovir alafenamide (TAF)/emtricitabine (FTC)+dolutegravir (DTG) and tenofovir disoproxil fumarate (TDF)/FTC+DTG, compared with TDF/FTC/efavirenz (EFV). We used top-down and bottom-up cost analysis with resource utilization based on trial data and adjusted to emulate routine care. We estimated the cost-effectiveness of each regimen as cost per person virally suppressed or retained and per life-year saved, at 48 and 96 weeks.Though the DTG-based trial arms were 2% more costly than TDF/FTC/EFV, both had slightly lower cost-per-outcome ($9783 and $9929/patient virally suppressed for TDF/FTC+DTG and TAF/FTC+DTG, respectively) than TDF/FTC/EFV ($10 365). The trial cost per additional virally suppressed patient, compared with TDF/FTC/EFV, was lower in the TDF/FTC+DTG arm ($2967) compared with TAF/FTC+DTG ($3430). In routine care, cost per virally suppressed patient was estimated as similar between TDF/FTC+DTG ($426) and TDF/FTC/EFV ($424) but more costly under TAF/FTC+DTG. Similar results were seen in the cost per additional person retained across scenarios. When modelled over 20 years, TDF/FTC+DTG was more cost-effective than TAF/FTC+DTG ($10 341 vs $41 958/life-year saved).TDF/FTC+DTG had similar costs per outcome as TDF/FTC/EFV in the routine care scenario but TDF/FTC+DTG was more cost-effective when modelled over 20 years.
科研通智能强力驱动
Strongly Powered by AbleSci AI