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Economic Analysis of Initial HIV Treatment: Efavirenz- versus Indinavir-Containing Triple Therapy

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Author Info

  • J. Jaime Caro

    (Caro Research, Concord, Massachusetts, USA)

  • Judith A. O'Brien

    (Caro Research, Concord, Massachusetts, USA)

  • Kristen Migliaccio-Walle

    (Caro Research, Concord, Massachusetts, USA)

  • Gabriel Raggio

    (Caro Research, Concord, Massachusetts, USA)

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    Abstract

    Objective: To compare the clinical and economic outcomes associated with triple therapy containing efavirenz or indinavir and 2 nucleoside reverse transcriptase inhibitors (NRTIs; zidovudine and lamivudine) in HIV-positive patients. Design and setting: An economic model based on viral load and CD4+ cell counts to predict long term outcomes such as progression to AIDS and AIDS-related death was developed and then analysed using data from a randomised clinical trial. Cost estimates from the healthcare system perspective were based on data from 6 state, all-payor databases, the AIDS Cost and Services Utilisation Study, and other literature. Analyses were carried out for time horizons between 5 and 15 years. Patients and interventions: HIV-positive patients with limited exposure to NRTIs. Initial regimens consisted of efavirenz or indinavir, each combined with 2 NRTIs. A maximum of 2 switches to other regimens was permitted. Main outcome measures and results: The efavirenz-containing triple therapy regimen was predicted to prolong survival at a savings of up to 10 923 US dollars (1998 values) relative to initial therapy with the indinavir-containing regimen. Patients who receive efavirenz are expected to have 11% greater survival at 5 years and fewer treatment failures (28 vs 52%, at 2 years). Overall, the economic and health benefits predicted for the efavirenz-containing regimen were robust to reasonable variation in key parameters. Conclusions: The superior clinical trial outcomes for efavirenz-containing regimens should translate into substantial economic and health benefits.

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    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 19 (2001)
    Issue (Month): 1 ()
    Pages: 95-104
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:phecon:v:19:y:2001:i:1:p:95-104

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    Web page: http://pharmacoeconomics.adisonline.com/

    For corrections or technical questions regarding this item, or to correct its listing, contact: (Dave Dustin).

    Related research

    Keywords: Cost analysis; Efavirenz; HIV infections; Indinavir; Pharmacoeconomics;

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