English, Article edition: Economic Analysis of Initial HIV Treatment: Efavirenz- versus Indinavir-Containing Triple Therapy J. Jaime Caro; Judith A. O'Brien; Kristen Migliaccio-Walle; ...

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Bookmark: http://trove.nla.gov.au/version/94116
Physical Description
  • article
Language
  • English

Edition details

Title
  • Economic Analysis of Initial HIV Treatment: Efavirenz- versus Indinavir-Containing Triple Therapy
Author
  • J. Jaime Caro
  • Judith A. O'Brien
  • Kristen Migliaccio-Walle
  • Gabriel Raggio
Physical Description
  • article
Notes
  • 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.
  • Cost analysis, Efavirenz, HIV infections, Indinavir, Pharmacoeconomics
  • RePEc:wkh:phecon:v:19:y:2001:i:1:p:95-104
Language
  • English
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