Assessing the cost-effectiveness of HAART for adults with HIV in England.
OBJECTIVE
To assess the cost-effectiveness of highly active antiretroviral therapy (HAART) compared with two nucleoside reverse transcriptase inhibitors (NRTIs) for HIV infected individuals.


METHODS
Different data sources on the clinical effects and costs of treatments were combined using a Markov model.


METHODS
English HIV treatment centres. Perspective UK public finance.


METHODS
HAART - dual NRTI therapy plus a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor - vs. dual NRTI therapy.


METHODS
Hypothetical cohorts of 1000 individuals infected with HIV. Outcome measures Projected life expectancy, cost-effectiveness in UK pound per life-year saved and per quality-adjusted life-years (QALYs) saved.


RESULTS
Assuming a 2-year additional treatment effect of therapy with HAART produced incremental cost-effectiveness ratios of pound14 602 per life-year saved and pound17 698 per QALY saved.


CONCLUSIONS
The results were sensitive to a number of assumptions including the cost of HAART and the discount rate, but they suggest that the use of HAART in England is at least moderately cost-effective compared with treatment with two NRTIs alone.
Miners
A H
AH
Royal Free Centre for HIV Medicine, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK. alec@rfhsm.ac.uk
Sabin
C A
CA
Trueman
P
P
Youle
M
M
Mocroft
A
A
Johnson
M
M
Beck
E J
EJ
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics*; D003362:Cost-Benefit Analysis; D004739:England; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D018894:Reverse Transcriptase Inhibitors / Q000191:economics*
D018894:Reverse Transcriptase Inhibitors