TITLE

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

AUTHOR(S)
Brogan, Anita J.; Mrus, Joseph; Hill, Andrew; Sawyer, Anthony W.; Smets, Erik
PUB. DATE
May 2010
SOURCE
HIV Clinical Trials;May/Jun2010, Vol. 11 Issue 3, p133
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: 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. Methods: 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 acid < 50 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. Results: 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. Conclusion: 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.
ACCESSION #
53110444

 

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