The cost-effectiveness of triple nucleoside analogue therapy antiretroviral regimens in the treatment of HIV in the United Kingdom.
OBJECTIVE
Treatment of HIV infection has improved markedly in recent years due to the use of combination antiretroviral therapies. However, the cost of these treatments remains a concern for those who fund health services. This article reports the results of an economic evaluation to determine the incremental cost-effectiveness of triple combination nucleoside analogue (NA) therapy compared with dual NA therapy.


METHODS
A Markov model was developed to assess the incremental cost effectiveness of triple therapy treatment versus dual therapy treatment. Clinical data was derived from published clinical trials and large observational cohorts whilst cost data was derived from a prospective database that monitors health care resource use in the UK HIV population.


RESULTS
The model predicted that triple NA combination treatment extended life expectancy by an additional 1.2 years compared with dual therapy NA treatment with an incremental cost-effectiveness ratio of 8,419 pounds per life-year saved. The incremental cost per quality-adjusted life-year (QALY) was estimated to be between 10,072-16,168 pounds per QALY gained depending on the assumptions.


CONCLUSIONS
The results show triple nucleoside analogue therapy to be a cost effective means of delaying HIV progression and extending life expectancy. However, further research into this issue is warranted.
Trueman
P
P
Global Health Outcomes, GlaxoWellcome R&D, Greenford, Middlesex, UK.
Youle
M
M
Sabin
C A
CA
Miners
A H
AH
Beck
E J
EJ
D019380:Anti-HIV Agents / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics*; D006801:Humans; D008390:Markov Chains; D008954:Models, Biological; D011788:Quality of Life; D018894:Reverse Transcriptase Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D006113:United Kingdom
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors