title: [Costs and cost-efficacy analysis of the preferred treatments by GESIDA/National Plan for AIDS for the initial antiretroviral therapy in adult human immunodeficiency virus (HIV) infected patients in 2012].
abstract: BACKGROUND
  The GESIDA and National AIDS Plan panel of experts propose «preferred regimens» of antiretroviral treatment (ART) as initial therapy in HIV infected patients for 2012. The objective of this study is to evaluate the costs and the efficiency of initiating treatment with these «preferred regimens».
  
  
  METHODS
  Economic assessment of costs and efficiency (cost/efficacy) using decision tree analysis model. Efficacy was defined as the probability of having a viral load <50 copies/ml at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regime was defined as the costs of ART and all its consequences (adverse effects, changes of ART regime, and drug resistance analyses) during the first 48 weeks. The perspective of the analysis is that of the National Health System, considering only differential direct costs: ART (official prices), management of adverse effects, studies of resistance and determination of HLA B 5701. The setting is Spain and the costs are those of 2012. A sensitivity deterministic analysis was conducted, building three scenarios for each regime: baseline, most favourable, and most unfavourable cases.
  
  
  RESULTS
  In the baseline case scenario, the cost of initiating treatment ranges from 6,895 euros for TDF/FTC+NVP to 12,067 euros for TDF/FTC+RAL. The efficacy ranges between 0.66 for ABC/3TC+LPV/r and 0.87 for TDF/FTC+RAL. Efficiency, in terms of cost/efficacy, varies between 9,387 and 13,823 euros per responder at 48 weeks, for TDF/FTC/EFV and TDF/FTC+RAL, respectively. In the most unfavourable scenario, the most efficient regime is TDF/FTC+NVP (9,742 per responder).
  
  
  CONCLUSIONS
  Considering the official prices of ART, the most efficient regimens are TDF/FTC/EFV (baseline case and most favourable scenarios), and TDF/FTC+NVP (most unfavourable scenario).
authors.affiliation: Técnicas Avanzadas de Investigación en Servicios de Salud (TAISS), Madrid, España.
authors.forename: Antonio Javier
authors.initials: AJ
authors.lastname: Blasco
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Arribas
authors.forename: Vicente
authors.initials: V
authors.lastname: Boix
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Clotet
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
authors.forename: Hernando
authors.initials: H
authors.lastname: Knobel
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: López
authors.forename: Josep M
authors.initials: JM
authors.lastname: Llibre
authors.forename: Fernando
authors.initials: F
authors.lastname: Lozano
authors.forename: José M
authors.initials: JM
authors.lastname: Miró
authors.forename: Daniel
authors.initials: D
authors.lastname: Podzamczer
authors.forename: Juan Miguel
authors.initials: JM
authors.lastname: Santamaría
authors.forename: Montserrat
authors.initials: M
authors.lastname: Tuset
authors.forename: Laura
authors.initials: L
authors.lastname: Zamora
authors.forename: Pablo
authors.initials: P
authors.lastname: Lázaro
authors.forename: Josep M
authors.initials: JM
authors.lastname: Gatell
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics; D002985:Clinical Protocols; D002986:Clinical Trials as Topic / Q000191:economics; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D019468:Disease Management; D016527:Drug Costs / Q000706:statistics & numerical data; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination / Q000191:economics; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D018803:Models, Economic; D009313:National Health Programs / Q000191:economics*; D017410:Practice Guidelines as Topic; D011306:Prescription Fees / Q000706:statistics & numerical data; D012955:Societies, Medical; D013030:Spain
chemical_list: D019380:Anti-HIV Agents