Gilles Hejblum, Samih Daher, Paul Moulaire, Karine Amat, Sidonie Lambert-Niclot, Clotilde Allavena, Christine Katlama, Karine Lacombe, Diane Ponscarme, Jade Ghosn, Severine Gibowski, Jean-Claude Alvarez, Jacqueline Capeau, Laurence Morand-Joubert, Dominique Costagliola, Pierre De Truchis, Roland Landman, Lambert Assoumou
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引用次数: 0
Abstract
Objective: The ANRS 170 QUATUOR study demonstrated the noninferiority of a triple antiretroviral therapy (ART) taken 4 consecutive days on and 3 days off (hereafter referred to as a 4/7-days strategy) compared to a triple therapy taken 7 days a week (7/7-days strategy) for persons living with HIV and with suppressed viremia. We investigated corresponding cost-effectiveness issues.
Design: Cost-effectiveness study.
Setting: France.
Subject, participants: All 636 persons involved in the primary analysis of the QUATUOR trial (318 per arm). Analyses were based on 10,000 simulations replicating the trial. Additional analyses included estimating the national impact of spreading the 4/7-days strategy all over France.
Intervention: a 4/7-days strategy, compared to a 7/7-days strategy.
Main outcome measures: Effectiveness was considered as the noninferiority of the 4/7-days strategy, main criterion of the trial primary analysis. Direct health resource costs (year2022€) were considered and included costs for ART, laboratory tests, co-medications, hospitalizations, and medical consultations.
Results: The mean individual costs for ART were € 3,678 (95% confidence interval: 3,593-3,763) and € 6,450 (6,301-6,596) in the 4/7-days and 7/7-days arm, respectively (p < 0.0001), and constituted the single element with a statistical difference between the two strategies. Adopting a 4/7-days regimen in 20% of the potential recipients in France was estimated to provide annual savings of € 61,752,467 (61,569,005-61,925,136).
Conclusions: The 4/7-day strategy dominates the 7/7-day strategy, providing substantial ART-related cost savings while maintaining treatment effectiveness. Study results support generalizing the proposal of 4/7-days regimens in France, in persons eligible for this strategy.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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