A H Miners1, C A Sabin, P Trueman, M Youle, A Mocroft, M Johnson, E J Beck. 1. Royal Free Centre for HIV Medicine, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK. alec@rfhsm.ac.uk
Abstract
OBJECTIVE: To assess the cost-effectiveness of highly active antiretroviral therapy (HAART) compared with two nucleoside reverse transcriptase inhibitors (NRTIs) for HIV infected individuals. DESIGN: Different data sources on the clinical effects and costs of treatments were combined using a Markov model. SETTING: English HIV treatment centres. Perspective UK public finance. INTERVENTIONS: HAART - dual NRTI therapy plus a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor - vs. dual NRTI therapy. PARTICIPANTS: Hypothetical cohorts of 1000 individuals infected with HIV. Outcome measures Projected life expectancy, cost-effectiveness in UK pound per life-year saved and per quality-adjusted life-years (QALYs) saved. RESULTS: Assuming a 2-year additional treatment effect of therapy with HAART produced incremental cost-effectiveness ratios of pound14 602 per life-year saved and pound17 698 per QALY saved. CONCLUSIONS: The results were sensitive to a number of assumptions including the cost of HAART and the discount rate, but they suggest that the use of HAART in England is at least moderately cost-effective compared with treatment with two NRTIs alone.
OBJECTIVE: To assess the cost-effectiveness of highly active antiretroviral therapy (HAART) compared with two nucleoside reverse transcriptase inhibitors (NRTIs) for HIV infected individuals. DESIGN: Different data sources on the clinical effects and costs of treatments were combined using a Markov model. SETTING: English HIV treatment centres. Perspective UK public finance. INTERVENTIONS: HAART - dual NRTI therapy plus a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor - vs. dual NRTI therapy. PARTICIPANTS: Hypothetical cohorts of 1000 individuals infected with HIV. Outcome measures Projected life expectancy, cost-effectiveness in UK pound per life-year saved and per quality-adjusted life-years (QALYs) saved. RESULTS: Assuming a 2-year additional treatment effect of therapy with HAART produced incremental cost-effectiveness ratios of pound14 602 per life-year saved and pound17 698 per QALY saved. CONCLUSIONS: The results were sensitive to a number of assumptions including the cost of HAART and the discount rate, but they suggest that the use of HAART in England is at least moderately cost-effective compared with treatment with two NRTIs alone.
Authors: Edward M Gardner; Moises E Maravi; Cornelis Rietmeijer; Arthur J Davidson; William J Burman Journal: Appl Health Econ Health Policy Date: 2008 Impact factor: 2.561
Authors: Keith Cooper; Jonathan Shepherd; Jo Picot; Jeremy Jones; Josephine Kavanagh; Angela Harden; Elaine Barnett-Page; Andrew Clegg; Debbie Hartwell; Geoff Frampton; Alison Price Journal: Int J Technol Assess Health Care Date: 2012-09-21 Impact factor: 2.188
Authors: Gesine Meyer-Rath; Alana T Brennan; Matthew P Fox; Tebogo Modisenyane; Nkeko Tshabangu; Lerato Mohapi; Sydney Rosen; Neil Martinson Journal: J Acquir Immune Defic Syndr Date: 2013-03-01 Impact factor: 3.731