The cost-effectiveness analysis of initiating HIV/AIDS treatment with efavirenz-based regimens compared with nevirapine-based regimens in Thailand.
OBJECTIVE
The aim of this study is to evaluate the cost-utility of the treatment, starting with EFZ-based therapy, compared with NVP-based therapy in Thai HIV/AIDS patients.


METHODS
The study adopted a health care provider perspective. A probabilistic Markov model was applied to Thai HIV/AIDS patients aged 15 to 65 years. Input parameters were extracted from a cohort study of four regional hospitals. The study explored the effects of uncertainty around input parameters.


RESULTS
For those patients with a different baseline CD4, initial therapy using EFZ-based regimens was the preferable choice for all subgroups. Given a maximum acceptable willingness to pay (WTP) threshold of 300,000 Baht/DALY averted starting with EFZ-based regimens was cost-effective for patients with a baseline CD4 count less than 250 cells/mm3 and in all patient age groups, except those who were 20 years old.


CONCLUSIONS
The results suggest that starting with EFZ-based regimens was the preferable choice and it should be used as the first line regimen for Thai HIV/AIDS patients.
Maleewong
Usawadee
U
The Faculty of Pharmacy, Mahasarakham University, Thailand. usawadee_m@yahoo.com
Kulsomboon
Vithaya
V
Teerawattananon
Yot
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000480:Alkynes; D019380:Anti-HIV Agents / Q000191:economics* / Q000627:therapeutic use; D048588:Benzoxazines / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003521:Cyclopropanes; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D019829:Nevirapine / Q000191:economics* / Q000627:therapeutic use; D011336:Probability; D019057:Quality-Adjusted Life Years; D018894:Reverse Transcriptase Inhibitors / Q000191:economics / Q000627:therapeutic use; D013785:Thailand; D055815:Young Adult
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine; C098320:efavirenz