Cost/efficacy analysis of preferred Spanish AIDS study group regimens and the dual therapy with lopinavir/ritonavir plus lamivudine for initial ART in HIV infected adults.
BACKGROUND
The National AIDS Plan and the Spanish AIDS study group (GESIDA) proposes "preferred regimens" (PR) of antiretroviral treatment (ART) as initial therapy in HIV-infected patients. In 2013, the recommended regimens were all triple therapy regimens. The Gardel Study assessed the efficacy of a dual therapy (DT) combination of lopinavir/ritonavir (LPV/r) plus lamivudine (3TC). Our objective is to evaluate the GESIDA PR and the DT regimen LPV/r+3TC cost/efficacy ratios.


METHODS
Decision tree models were built.


RESULTS
probability of having viral load <50 copies/mL at week 48. ART regime cost: costs of ART, adverse effects, and drug resistance tests during the first 48 weeks.


RESULTS
Cost/efficacy ratios varied between 5,817 and 13,930 euros per responder at 48 weeks, for the DT of LPV/r+3TC and tenofovir DF/emtricitabine+raltegravir, respectively.


CONCLUSIONS
Taking into account the official Spanish prices of ART, the most efficient regimen was DT of LPV/r+3TC, followed by the triple therapy with non-nucleoside containing regimens.
Head Infectious Diseases and AIDS Units, Hospital Clinic-IDIBAPS, Barcelona, Spain.
Josep María
JM
Gatell Artigas
HIV Unit, La Paz Hospital, IdiPAZ, Madrid, Spain.
José Ramón
JR
Arribas López
Independent Researcher, Madrid, Spain. Electronic address: plazaro@gmx.es.
Pablo
P
Lázaro Y de Mercado
Independent Researcher, Madrid, Spain.
Antonio Javier
AJ
Blasco Bravo
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D004359:Drug Therapy, Combination / Q000191:economics; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000191:economics* / Q000627:therapeutic use; D061466:Lopinavir / Q000191:economics* / Q000627:therapeutic use*; D019438:Ritonavir / Q000191:economics* / Q000627:therapeutic use; D013030:Spain; D019562:Viral Load
D019380:Anti-HIV Agents; D061466:Lopinavir; D019259:Lamivudine; D019438:Ritonavir
AIDS; Antiretroviral therapy; Cost; Coste; Efficacy; Efficiency; Eficacia; Eficiencia; HIV; SIDA; Terapia antirretroviral; VIH