Cost-effectiveness of enfuvirtide for treatment-experienced patients with HIV in Italy

Details

Serval ID
serval:BIB_12F79A29BACA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cost-effectiveness of enfuvirtide for treatment-experienced patients with HIV in Italy
Journal
HIV Clinical Trials
Author(s)
Hornberger  J., Green  J., Wintfeld  N., Cavassini  M., Rockstroh  J., Giuliani  G., De Carli  C., Lazzarin  A.
ISSN
1528-4336 (Print)
Publication state
Published
Issued date
04/2005
Volume
6
Number
2
Pages
92-102
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Mar-Apr
Abstract
BACKGROUND: Enfuvirtide (ENF) plus an optimized background (OB) antiretroviral regimen delays virological failure (VF), reduces HIV-1 viral load, and increases CD4 count compared with OB only in pretreated patients. PURPOSE: To forecast long-term outcomes, costs, and cost-effectiveness of ENF+OB vs. OB in the Italian health care system. METHOD: A Markov model was developed and clinical trial results on viral suppression and CD4 count were linked with data from HAART-era studies of the risk of AIDS-defining events (ADEs) and death. Resource data were obtained from Italian sources on direct medical costs. Cost-effectiveness was computed as the incremental cost per quality-adjusted life year (QALY) saved. RESULTS: Patients receiving ENF+OB were projected to experience a mean time to virological failure of 1.0 years vs. 0.5 years for OB and mean time to immunological failure of 3.1 years vs. 1.3 years for OB. Life expectancy and QALYs were greater for ENF+OB than OB by 1.8 and 1.5 years, respectively. Total lifetime medical cost was euro 126,487 for ENF+OB and euro 84,416 for OB, a difference of euro 42,071 due to the cost of ENF itself (euro 18,400) and the medical costs associated with additional life expectancy (euro 23,671). The incremental cost-effectiveness of ENF+OB was euro 23,721 per life year (euro 28,669 per QALY). CONCLUSION: ENF+OB is predicted to increase life expectancy at a cost per life year that is comparable to many well-accepted therapies in Europe.
Keywords
CD4 Lymphocyte Count Cost-Benefit Analysis Disease Progression Drug Therapy, Combination HIV Envelope Protein gp41/*economics/therapeutic use HIV Fusion Inhibitors/*economics/therapeutic use HIV Infections/*drug therapy/*economics Humans Italy Markov Chains Models, Biological Peptide Fragments/*economics/therapeutic use Quality of Life Treatment Failure
Pubmed
Web of science
Create date
24/01/2008 20:44
Last modification date
20/08/2019 12:41
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