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Optimal sequencing of antiretroviral drug cocktails under uncertainty and irreversibility

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  • Bezabih, Mintewab
  • Stolpe, Michael

Abstract

This paper develops a real options approach to the optimal sequencing of antiretroviral drug cocktails for HIV/AIDS patients in resource-poor settings. The analysis focuses on the implications of endogenous resistance mutations in the virus that reduce or eliminate the effectiveness of individual drugs within a cocktail when lack of laboratory equipment prevents these from being identified. Using a model with two drug cocktails, we show that the first-line therapy should be introduced later than in the case without resistance mutations and that the second-line therapy should be introduced earlier. We go on to discuss implications for comparative cost-effectiveness analyses.

Suggested Citation

  • Bezabih, Mintewab & Stolpe, Michael, 2007. "Optimal sequencing of antiretroviral drug cocktails under uncertainty and irreversibility," Kiel Working Papers 1371, Kiel Institute for the World Economy (IfW Kiel).
    • Handle: RePEc:zbw:ifwkwp:1371
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    File URL: https://www.econstor.eu/bitstream/10419/4239/1/KAP-1371.pdf
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    References listed on IDEAS

    as
    1. Avinash K. Dixit & Robert S. Pindyck, 1994. "Investment under Uncertainty," Economics Books, Princeton University Press, edition 1, number 5474.
    2. Bar-Ilan, Avner & Strange, William C., 1998. "A model of sequential investment," Journal of Economic Dynamics and Control, Elsevier, vol. 22(3), pages 437-463, March.
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    More about this item

    Keywords

    Real option theory; Cost-effectiveness analysis; Combination therapy; Developing countries; HIV/AIDS;
    All these keywords.

    JEL classification:

    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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