Cost-effectiveness analysis comparing chemotherapy regimens in the treatment of AIDS-related Kaposi's sarcoma in Brazil.
BACKGROUND
Economic analyses of agents used in the treatment of AIDS and opportunistic diseases are particularly important in developing countries.


OBJECTIVE
To analyze the cost-effectiveness of AIDS-related Kaposi's sarcoma (AIDS-KS) chemotherapy regimens in Brazil.


METHODS
A decision-analysis model was developed, and effectiveness data were derived from randomized phase III trials evaluating pegylated liposomal doxorubicin (PLD), liposomal daunorubicin (DNX), and the ABV regimen (doxorubicin, bleomycin, and vincristine). Resource data on direct medical costs were obtained from local sources.


RESULTS
The cost-effectiveness estimates (defined as average costs per patient who responds completely or partially) favored PLD (US $10,272/responder) in comparison to DNX (US $16,263/responder). Regarding cost-effectiveness, the ABV regimen that is widely used in developing countries had better results when compared to both PLD (US $1,268 vs. US $10,271) and DNX (US $1,268 vs. US $16,260). The incremental cost per additional responder of using PLD instead of ABV was US $20,990. Sensitivity analyses suggest that these results hold over a wide range of assumptions.


CONCLUSIONS
ABV seems to be the most reasonable treatment option for AIDS-KS patients in resource-limited countries like Brazil.
Vanni
Tazio
T
Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Fonseca
Benedito Antonio Lopes
BA
Polanczyk
Carisi Anne
CA
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000191:economics*; D000284:Administration, Oral; D000903:Antibiotics, Antineoplastic / Q000191:economics* / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000191:economics / Q000627:therapeutic use; D001761:Bleomycin / Q000191:economics / Q000627:therapeutic use; D001938:Brazil; D003362:Cost-Benefit Analysis; D003630:Daunorubicin / Q000191:economics / Q000627:therapeutic use; D003661:Decision Support Techniques; D004317:Doxorubicin / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D008081:Liposomes / Q000191:economics; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000191:economics*; D012680:Sensitivity and Specificity; D014750:Vincristine / Q000191:economics / Q000627:therapeutic use
D000903:Antibiotics, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D008081:Liposomes; D001761:Bleomycin; D011092:Polyethylene Glycols; D014750:Vincristine; D004317:Doxorubicin; D003630:Daunorubicin