OBJECTIVE: To compare the estimated long-term outcomes, costs, and cost-effectiveness of tipranavir boosted with ritonavir (TPV/r) versus investigator-selected ritonavir-boosted comparator protease inhibitor (CPI/r) using the observed 48-week data from the RESIST trials in a previously published Markov model. METHOD: A previously developed 3-stage Markov model was modified to reflect US practice patterns for treatment-experienced HIV patients using 2007 costs and combined phase III tipranavir trial data (RESIST-1 and -2). The 12 model health states were defined by CD4 cell count and viral load that have previously been identified as predictors of HIV/AIDS progression. Resource use and quality of life weights were linked to each health state. Disease progression beyond the 48-week trial period was based on HAART treatment-experienced patients from data collected by the University of South Carolina. Costs were estimated from the payer perspective. RESULTS: TPV/r patients remained longer in health states defined by higher CD4 cell count and lower viral load compared to CPI/r patients. This reduced the rate of AIDS-defining events by 12.35% over 5 years and resulted in 0.64 quality-adjusted life-years (QALYs) gained (discounted at 3%) over the model time horizon (remaining lifetime). The incremental cost-effectiveness ratio (ICER) of TPV/r versus CPI/r was $56,517/QALY (discounted at 3%). Excluding patients also treated with enfuvirtide reduced the ICER to $46,147/QALY. CONCLUSION: TPVI/r is cost-effective in the United States compared to CPI/r in treatment-experienced HIV-1-infected patients.
OBJECTIVE: To compare the estimated long-term outcomes, costs, and cost-effectiveness of tipranavir boosted with ritonavir (TPV/r) versus investigator-selected ritonavir-boosted comparator protease inhibitor (CPI/r) using the observed 48-week data from the RESIST trials in a previously published Markov model. METHOD: A previously developed 3-stage Markov model was modified to reflect US practice patterns for treatment-experienced HIVpatients using 2007 costs and combined phase III tipranavir trial data (RESIST-1 and -2). The 12 model health states were defined by CD4 cell count and viral load that have previously been identified as predictors of HIV/AIDS progression. Resource use and quality of life weights were linked to each health state. Disease progression beyond the 48-week trial period was based on HAART treatment-experienced patients from data collected by the University of South Carolina. Costs were estimated from the payer perspective. RESULTS: TPV/rpatients remained longer in health states defined by higher CD4 cell count and lower viral load compared to CPI/rpatients. This reduced the rate of AIDS-defining events by 12.35% over 5 years and resulted in 0.64 quality-adjusted life-years (QALYs) gained (discounted at 3%) over the model time horizon (remaining lifetime). The incremental cost-effectiveness ratio (ICER) of TPV/r versus CPI/r was $56,517/QALY (discounted at 3%). Excluding patients also treated with enfuvirtide reduced the ICER to $46,147/QALY. CONCLUSION:TPVI/r is cost-effective in the United States compared to CPI/r in treatment-experienced HIV-1-infectedpatients.
Authors: Ahmed M Bayoumi; Paul G Barnett; Vilija R Joyce; Susan C Griffin; Huiying Sun; Nick J Bansback; Mark Holodniy; Gillian Sanders; Sheldon T Brown; Tassos C Kyriakides; Brian Angus; D William Cameron; Aslam H Anis; Mark Sculpher; Douglas K Owens Journal: J Acquir Immune Defic Syndr Date: 2013-12-01 Impact factor: 3.731
Authors: Anita J Brogan; Erik Smets; Josephine A Mauskopf; Sarah A L Manuel; Ines Adriaenssen Journal: Pharmacoeconomics Date: 2014-09 Impact factor: 4.981
Authors: Kit N Simpson; Birgitta Dietz; Robert W Baran; Kevin W Garren; Sharon A Riddler; Menaka Bhor; Richard H Haubrich Journal: Cost Eff Resour Alloc Date: 2011-05-08