Análisis de los costes asociados a la administración intramuscular versus oral de la terapia antirretroviral en el manejo de la infección por el virus de la inmunodeficiencia humana

IF 2.6 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica Pub Date : 2025-05-01 DOI:10.1016/j.eimc.2024.07.013

Vicente Estrada , Juan Emilio Losa , Ramón Morillo-Verdugo , Montserrat Pérez-Encinas , Jesús Santos , Antonio Castro , María Presa González , Laura Salinas-Ortega

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引用次数: 0

Abstract

Objetive

To identify and analyze the resources and costs associated with the administration of intramuscular antiretroviral therapy (ART) cabotegravir + rilpivirine (CAB + RPV) compared to oral ART in the management of Human Immunodeficiency Virus Type 1 (HIV-1) infection in Spain.

Methods

An economic model was developed to identify resources and analyze costs from the perspective of the National Health System (NHS) and societal, associated with the administration of intramuscular ART (CAB + RPV) compared to oral ART over a two-year time horizon. Costs included treatment change monitoring, pharmaceutical dispensation, administration, management of adverse events to injection-site reactions (AEs-ISR), travel to the hospital, telepharmacy service, and lost work productivity. Unit costs (€, 2023) were obtained from the literature. Sensitivity analyses were conducted to evaluate the robustness of the model.

Results

Intramuscular ART compared to oral ART was associated with an increase in costs of €673.16/patient over two years from the perspective of the NHS, and €719.59/patient from the social perspective. Intramuscular ART would generate increased costs for dispensation (+€97.75), administration (+€394.55), monitoring (+€288.74), management of AEs-ISR (+€6.46), travel (+€8.36), and lost work productivity (+€38.07), compared to oral ART administration.

Conclusion

Treating HIV-1 with intramuscular CAB + RPV leads to increased resource consumption and costs, compared to oral ART.

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在控制人体免疫缺陷病毒感染方面，肌肉内与口服抗逆转录病毒治疗的相关费用分析

目的确定和分析在西班牙治疗人类免疫缺陷病毒1型（HIV-1）感染时肌肉注射抗逆转录病毒治疗（ART）卡博特格拉韦+利匹韦林（CAB + RPV）与口服抗逆转录病毒治疗（ART）的资源和成本。方法建立了一个经济模型，从国家卫生系统（NHS）和社会的角度确定资源并分析成本，在两年的时间范围内，与口服ART相比，肌肉注射ART （CAB + RPV）的管理相关。费用包括治疗变化监测、药物分配、管理、注射部位不良反应（ae - isr）的管理、前往医院的差旅费、远程药房服务和丧失的工作效率。单位成本（€，2023）从文献中获得。进行敏感性分析以评价模型的稳健性。结果从NHS的角度来看，肌痉挛ART与口服ART相比，两年内成本增加673.16欧元/患者，从社会角度来看，成本增加719.59欧元/患者。与口服ART相比，肌内ART会增加分配（+ 97.75欧元）、管理（+ 394.55欧元）、监测（+ 288.74欧元）、ae - isr管理（+ 6.46欧元）、旅行（+ 8.36欧元）和工作效率损失（+ 38.07欧元）的成本。结论与口服ART相比，肌内注射CAB + RPV治疗HIV-1会增加资源消耗和成本。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Enfermedades infecciosas y microbiologia clinica 医学-传染病学

CiteScore

2.10

自引率

8.00%

发文量

194

审稿时长

29 days

期刊介绍： Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.