title: [Analysis of costs and cost-effectiveness of preferred GESIDA/National AIDS Plan regimens for initial antiretroviral therapy in human immunodeficiency virus infected adult patients in 2013].
abstract: BACKGROUND
  The GESIDA and National AIDS Plan panel of experts have proposed "preferred regimens" of antiretroviral treatment (ART) as initial therapy in HIV infected patients for 2013. The objective of this study is to evaluate the costs and effectiveness of initiating treatment with these "preferred regimens".
  
  
  METHODS
  An economic assessment of costs and effectiveness (cost/effectiveness) was performed using decision tree analysis models. Effectiveness was defined as the probability of having viral load <50copies/mL at week48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regime was defined as the costs of ART and its consequences (adverse effects, changes of ART regime and drug resistance analyses) during the first 48weeks. The perspective of the analysis is that of the National Health System was applied, only taking into account differential direct costs: ART (official prices), management of adverse effects, resistance studies, and determination of HLA B*5701. The setting is Spain and the costs are those of 2013. A sensitivity deterministic analysis was performed, constructing three scenarios for each regimen: baseline, most favourable, and most unfavourable cases.
  
  
  RESULTS
  In the baseline case scenario, the cost of initiating treatment ranges from 6,747euros for TDF/FTC+NVP to 12,059euros for TDF/FTC+RAL. The effectiveness ranges between 0.66 for ABC/3TC+LPV/r and ABC/3TC+ATV/r, and 0.87 for TDF/FTC+RAL and ABC/3TC+RAL. Effectiveness, in terms of cost/effectiveness, varies between 8,396euros and 13,930euros per responder at 48weeks, for TDF/FTC/RPV and TDF/FTC+RAL, respectively.
  
  
  CONCLUSIONS
  Taking ART at official prices, the most effective regimen was TDF/FTC/RPV, followed by the rest of non-nucleoside containing regimens. The sensitivity analysis confirms the robustness of these findings.
authors: Técnicas Avanzadas de Investigación en Servicios de Salud (TAISS), Madrid, España.
authors: Antonio Javier
authors: AJ
authors: Blasco
authors: Josep M
authors: JM
authors: Llibre
authors: José Ramón
authors: JR
authors: Arribas
authors: Vicente
authors: V
authors: Boix
authors: Bonaventura
authors: B
authors: Clotet
authors: Pere
authors: P
authors: Domingo
authors: Juan
authors: J
authors: González-García
authors: Hernando
authors: H
authors: Knobel
authors: Juan Carlos
authors: JC
authors: López
authors: Fernando
authors: F
authors: Lozano
authors: José M
authors: JM
authors: Miró
authors: Daniel
authors: D
authors: Podzamczer
authors: Juan Miguel
authors: JM
authors: Santamaría
authors: Montserrat
authors: M
authors: Tuset
authors: Laura
authors: L
authors: Zamora
authors: Pablo
authors: P
authors: Lázaro
authors: Josep M
authors: JM
authors: Gatell
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000191:economics*; D000328:Adult; D044966:Anti-Retroviral Agents / Q000191:economics* / Q000627:therapeutic use*; D002985:Clinical Protocols / Q000592:standards*; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans
chemical_list: D044966:Anti-Retroviral Agents
keywords: AIDS; Antiretrovirals; Antirretrovirales; Cost; Costes; Effectiveness; Efficacy; Eficacia; Eficiencia; Human immunodeficiency virus; Sida; Therapy; Tratamiento; Virus de la inmunodeficiencia humana