title: Cost-effectiveness analysis comparing chemotherapy regimens in the treatment of AIDS-related Kaposi's sarcoma in Brazil.
abstract: 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.
authors.affiliation: Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
authors.forename: Tazio
authors.initials: T
authors.lastname: Vanni
authors.forename: Benedito Antonio Lopes
authors.initials: BA
authors.lastname: Fonseca
authors.forename: Carisi Anne
authors.initials: CA
authors.lastname: Polanczyk
mesh_terms: 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
chemical_list: D000903:Antibiotics, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D008081:Liposomes; D001761:Bleomycin; D011092:Polyethylene Glycols; D014750:Vincristine; D004317:Doxorubicin; D003630:Daunorubicin