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Cost-effectiveness analysis of antiretroviral drugs for treatment-naive HIV infection in China
INTRODUCTION: Dolutegravir (DTG)-based regimen was included in the expanded formulary of China's National Free Antiretroviral Treatment Program at the end of 2021. Yet high price of DTG and lack of health economic evaluation in China present barriers for implementation of the regimen. The study...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641994/ https://www.ncbi.nlm.nih.gov/pubmed/37953277 http://dx.doi.org/10.1186/s12889-023-17052-1 |
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author | Li, Min Cao, Yuxin Huang, Hao Qin, Gang Chu, Minjie Zou, Meiyin Zhuang, Xun |
author_facet | Li, Min Cao, Yuxin Huang, Hao Qin, Gang Chu, Minjie Zou, Meiyin Zhuang, Xun |
author_sort | Li, Min |
collection | PubMed |
description | INTRODUCTION: Dolutegravir (DTG)-based regimen was included in the expanded formulary of China's National Free Antiretroviral Treatment Program at the end of 2021. Yet high price of DTG and lack of health economic evaluation in China present barriers for implementation of the regimen. The study aims to investigate the lifetime cost-effectiveness of DTG-based regimen for treatment-naive HIV infection in China. METHODS: A decision-analytic Markov model was used to obtain the costs and effectiveness of four regimens: Arm A, efavirenz (EFV)-based regimen; Arm B, DTG-based regimen; Arm C, elvitegravir/cobicistat/tenofovir alafenamide/emtricitabine (EVG/c/FTC/TAF) regimen; Arm D, abacavir/lamivudine/dolutegravir (ABC/3TC/DTG) regimen. The potential impact of national centralized drug procurement policy was assessed in scenario analysis. The results were further validated through sensitivity analysis. RESULTS: Compared with other three regimens, DTG-based regimen led to the fewest cumulative adverse reactions, opportunistic infections and deaths. Compared with EFV-based regimen, the base-case ICERs for DTG-based regimen were 13,357 (USD/QALY) and 13,424 (USD/QALY) from the healthcare system and societal perspective respectively. In the policy scenario analysis with the procurement price of DTG equal to that of LPV/r, DTG-based regimen would be dominant. The model results remained robust in sensitivity analyses. CONCLUSIONS: DTG-based regimen for treatment-naive patients is likely to be cost-effective and deserve wider implementation in China. This study strongly suggests the centralized procurement of DTG to minimize cost and maximize cost-effectiveness. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-17052-1. |
format | Online Article Text |
id | pubmed-10641994 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-106419942023-11-14 Cost-effectiveness analysis of antiretroviral drugs for treatment-naive HIV infection in China Li, Min Cao, Yuxin Huang, Hao Qin, Gang Chu, Minjie Zou, Meiyin Zhuang, Xun BMC Public Health Research INTRODUCTION: Dolutegravir (DTG)-based regimen was included in the expanded formulary of China's National Free Antiretroviral Treatment Program at the end of 2021. Yet high price of DTG and lack of health economic evaluation in China present barriers for implementation of the regimen. The study aims to investigate the lifetime cost-effectiveness of DTG-based regimen for treatment-naive HIV infection in China. METHODS: A decision-analytic Markov model was used to obtain the costs and effectiveness of four regimens: Arm A, efavirenz (EFV)-based regimen; Arm B, DTG-based regimen; Arm C, elvitegravir/cobicistat/tenofovir alafenamide/emtricitabine (EVG/c/FTC/TAF) regimen; Arm D, abacavir/lamivudine/dolutegravir (ABC/3TC/DTG) regimen. The potential impact of national centralized drug procurement policy was assessed in scenario analysis. The results were further validated through sensitivity analysis. RESULTS: Compared with other three regimens, DTG-based regimen led to the fewest cumulative adverse reactions, opportunistic infections and deaths. Compared with EFV-based regimen, the base-case ICERs for DTG-based regimen were 13,357 (USD/QALY) and 13,424 (USD/QALY) from the healthcare system and societal perspective respectively. In the policy scenario analysis with the procurement price of DTG equal to that of LPV/r, DTG-based regimen would be dominant. The model results remained robust in sensitivity analyses. CONCLUSIONS: DTG-based regimen for treatment-naive patients is likely to be cost-effective and deserve wider implementation in China. This study strongly suggests the centralized procurement of DTG to minimize cost and maximize cost-effectiveness. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-17052-1. BioMed Central 2023-11-13 /pmc/articles/PMC10641994/ /pubmed/37953277 http://dx.doi.org/10.1186/s12889-023-17052-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Li, Min Cao, Yuxin Huang, Hao Qin, Gang Chu, Minjie Zou, Meiyin Zhuang, Xun Cost-effectiveness analysis of antiretroviral drugs for treatment-naive HIV infection in China |
title | Cost-effectiveness analysis of antiretroviral drugs for treatment-naive HIV infection in China |
title_full | Cost-effectiveness analysis of antiretroviral drugs for treatment-naive HIV infection in China |
title_fullStr | Cost-effectiveness analysis of antiretroviral drugs for treatment-naive HIV infection in China |
title_full_unstemmed | Cost-effectiveness analysis of antiretroviral drugs for treatment-naive HIV infection in China |
title_short | Cost-effectiveness analysis of antiretroviral drugs for treatment-naive HIV infection in China |
title_sort | cost-effectiveness analysis of antiretroviral drugs for treatment-naive hiv infection in china |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641994/ https://www.ncbi.nlm.nih.gov/pubmed/37953277 http://dx.doi.org/10.1186/s12889-023-17052-1 |
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