title: [Pharmacoeconomic analysis of a maintenance strategy with lopinavir/ritonavir monotherapy in HIV-infected patients].
abstract: OBJECTIVE
  To conduct a cost-efficacy analysis of lopinavir/ritonavir (LPV/r) monotherapy as a maintenance regimen following induction of virological response with triple therapy including LPV/r. The pharmacoeconomic analysis was performed from the perspective of the Spanish public health system.
  
  
  METHODS
  A cost-efficacy analysis was performed in a phase IV-II, comparative, randomized, multicenter, open-label clinical trial evaluating the efficacy and safety of maintenance therapy with LPV/r monotherapy versus continuation of triple therapy in HIV-infected patients with a persistently undetectable viral load for 6 months. For the pharmacoeconomic analysis, efficacy was defined as the proportion of patients with plasma HIV RNA concentrations < 50 copies/mL at 48 weeks from the start of the study. An intent-to-treat analysis was performed. Only direct costs were considered. Cost, efficacy and the cost-efficacy ratio were calculated for each treatment option.
  
  
  RESULTS
  The cost-efficacy ratio of LPV/r maintenance monotherapy was 5186 euros per unit of achieved effect (patient with plasma HIV RNA concentrations < 50 copies/mL at 48 weeks), whereas maintenance with triple therapy had a cost-efficacy ratio of 8688 euros per unit of achieved effect.
  
  
  CONCLUSIONS
  The option of LPV/r monotherapy as maintenance therapy in HIV-infected patients following induction of virological response with triple therapy including LPV/r might be a more efficient alternative than maintaining triple therapy, as evidenced by a more favorable cost-efficacy ratio.
authors.affiliation: Servicio de Farmacia, Hospital Universitario 12 de Octubre, Madrid, España. iescobar.hdoc@salud.madrid.org
authors.forename: Ismael
authors.initials: I
authors.lastname: Escobar
authors.forename: Federico
authors.initials: F
authors.lastname: Pulido
authors.forename: Esther
authors.initials: E
authors.lastname: Pérez
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Arribas
authors.forename: María Pilar
authors.initials: MP
authors.lastname: García
authors.forename: Asunción
authors.initials: A
authors.lastname: Hernando
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics*; D017320:HIV Protease Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D061466:Lopinavir; D008297:Male; D008875:Middle Aged; D011744:Pyrimidinones / Q000191:economics* / Q000627:therapeutic use*; D019438:Ritonavir / Q000191:economics* / Q000627:therapeutic use*
chemical_list: D017320:HIV Protease Inhibitors; D011744:Pyrimidinones; D061466:Lopinavir; D019438:Ritonavir