Short-term cost and efficiency analysis of raltegravir versus atazanavir/ritonavir or darunavir/ritonavir for treatment-naive adults with HIV-1 infection in Spain.

Q2 Medicine
Ashley E Davis, Anita J Brogan, Bridgett Goodwin, Gonzalo Nocea, Virginia Lozano
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引用次数: 2

Abstract

Introduction: The AIDS Clinical Trial Group (ACTG) 5257 clinical trial showed that raltegravir (RAL) was superior to atazanavir/ritonavir (ATV/r) and darunavir/ritonavir (DRV/r), when used in combination with emtricitabine/tenofovir DF (FTC/TDF), in a 96-week composite endpoint combining virologic efficacy and tolerability for treatment-naive adults with HIV-1 infection. This study aimed to estimate the efficiency associated with these three regimens in Spain.

Methods: An economic model was developed to estimate costs for antiretroviral drugs, adverse event management, and HIV care for individuals initiating first-line therapy. Antiretroviral drug costs were based on hospital costs with mandatory discounts applied. Adverse event management costs and HIV care costs were obtained from published sources and inflated to 2015 euros. Head-to-head efficacy and safety data (discontinuation rates, mean CD4 cell-count changes, adverse event incidence) up to 96 weeks for each regimen were obtained from the clinical trial. The efficiency of each regimen, as measured by the cost per successfully treated patient (i.e. on first-line therapy for 96 weeks), was estimated and examined in sensitivity analyses. All cost outcomes were discounted at 3.0% annually.

Results: Total costs per successfully treated patient were €22,377 for RAL, €26,629 for ATV/r, and €23,928 for DRV/r. These results were found to be robust in sensitivity analyses.

Discussion: RAL has the lowest cost per successfully treated patient when compared with DRV/r and ATV/r, each used in combination with FTC/TDF, for treatment-naive adults with HIV-1 infection in Spain. This economic evidence complements the clinical benefits of RAL reported in the ACTG 5257 clinical trial.

在西班牙,雷替格拉韦与阿扎那韦/利托那韦或达那韦/利托那韦治疗初治成人HIV-1感染的短期成本和效率分析
艾滋病临床试验组(ACTG) 5257临床试验显示,当雷替格拉韦(RAL)与恩曲他滨/替诺福韦DF (FTC/TDF)联合使用时,在96周的综合终点中,结合病毒学疗效和耐受性,对初次治疗的HIV-1感染成人患者优于阿扎那韦/利托那韦(ATV/r)和达鲁纳韦/利托那韦(DRV/r)。本研究旨在评估这三种治疗方案在西班牙的有效性。方法:开发了一个经济模型来估计抗逆转录病毒药物的成本,不良事件管理,以及对开始一线治疗的个体的艾滋病毒护理。抗逆转录病毒药物费用是根据医院费用计算的,并适用强制性折扣。不良事件管理成本和艾滋病毒护理成本从公开来源获得,并膨胀至2015欧元。从临床试验中获得了每个方案长达96周的疗效和安全性数据(停药率、平均CD4细胞计数变化、不良事件发生率)。每个方案的效率,通过每个成功治疗患者(即一线治疗96周)的成本来衡量,在敏感性分析中进行估计和检查。所有成本结果均以每年3.0%的折现率计算。结果:每个成功治疗患者的总成本为RAL 22,377欧元,ATV/r 26,629欧元,DRV/r 23,928欧元。这些结果在敏感性分析中被发现是稳健的。讨论:在西班牙,与DRV/r和ATV/r相比,RAL在治疗首次感染HIV-1的成人患者中,每个成功治疗患者的成本最低,两者均与FTC/TDF联合使用。这一经济证据补充了ACTG 5257临床试验中报告的RAL的临床益处。
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来源期刊
HIV Clinical Trials
HIV Clinical Trials 医学-传染病学
CiteScore
1.76
自引率
0.00%
发文量
0
审稿时长
>12 weeks
期刊介绍: HIV Clinical Trials is devoted exclusively to presenting information on the latest developments in HIV/AIDS clinical research. This journal enables readers to obtain the most up-to-date, innovative research from around the world.
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