Cost-Effectiveness Analysis of Lopinavir/Ritonavir Monotherapy Versus Standard Combination Antiretroviral Therapy in HIV-1 Infected Patients with Viral Suppression in France (ANRS 140 DREAM)
dc.rights.license | open | en_US |
dc.contributor.author | GARAY, O. U. | |
dc.contributor.author | NISHIMWE, M. L. | |
dc.contributor.author | BOUSMAH, M. A. | |
dc.contributor.author | JANAH, A. | |
dc.contributor.author | GIRARD, P. M. | |
hal.structure.identifier | Bordeaux population health [BPH] | |
dc.contributor.author | CHENE, Genevieve | |
hal.structure.identifier | Bordeaux population health [BPH] | |
dc.contributor.author | MOINOT, Laetitia | |
dc.contributor.author | SAGAON-TEYSSIER, L. | |
dc.contributor.author | MEYNARD, J. L. | |
dc.contributor.author | SPIRE, B. | |
dc.contributor.author | BOYER, S. | |
dc.date.accessioned | 2020-06-08T12:00:54Z | |
dc.date.available | 2020-06-08T12:00:54Z | |
dc.date.issued | 2019-12 | |
dc.identifier.issn | 2509-4254 (Electronic) 2509-4262 (Linking) | en_US |
dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/7813 | |
dc.description.abstractEn | BACKGROUND: Protease inhibitor monotherapy is a simplified treatment strategy for virally suppressed HIV-positive patients that has the potential for cost savings, as fewer drugs are used than with combination therapy. However, evidence for its economic value is limited. OBJECTIVES: We assessed the cost-effectiveness of lopinavir/ritonavir monotherapy followed by treatment intensification in case of viral load rebound versus combination antiretroviral therapy (cART) with efavirenz/emtricitabine/tenofovir in HIV-1 infected patients with viral suppression in the ANRS 140 DREAM trial. METHODS: DREAM was conducted in 36 French Hospitals between 2009 and 2013. For each treatment strategy, we estimated the unadjusted and multivariate-adjusted mean costs (in euro, year 2010 values) and quality-adjusted life-years (QALYs) per patient, as well as incremental costs and QALYs per patient. We then assessed uncertainty using the cost-effectiveness acceptability curve, scenario analyses and cost-effectiveness price-threshold (CEPT) analysis. RESULTS: In the base-case analysis considering 2009-2013 antiretroviral drug (ARV) prices, adjusted incremental costs and QALYs were - euro3296 (95% confidence interval [CI] - 5202 to - 1391) and 0.006 (95% CI - 0.021 to 0.033), respectively, over 2 years, suggesting that monotherapy was cost-effective with a probability of 100% at various cost-effectiveness thresholds. In scenario analyses considering 2018 ARV prices, monotherapy remained cost-effective but with a lower probability (94% vs. 100% in the base-case analysis). The current price of cART would have to decrease by 34% to be cost-effective with a probability of 95%. CONCLUSION: Monotherapy appears to be cost-effective compared with cART for virologically suppressed HIV-positive patients in France. CEPT analysis is a useful tool to identify the preferred strategy to adopt given that ARV prices change rapidly. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT00946595. | |
dc.language.iso | EN | en_US |
dc.rights | Attribution-NonCommercial 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ | |
dc.subject.en | MORPH3Eus | |
dc.title.en | Cost-Effectiveness Analysis of Lopinavir/Ritonavir Monotherapy Versus Standard Combination Antiretroviral Therapy in HIV-1 Infected Patients with Viral Suppression in France (ANRS 140 DREAM) | |
dc.title.alternative | Pharmacoecon Open | en_US |
dc.type | Article de revue | en_US |
dc.identifier.doi | 10.1007/s41669-019-0130-7 | en_US |
dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
dc.identifier.pubmed | 30968368 | en_US |
bordeaux.journal | Pharmacoecon Open | en_US |
bordeaux.page | 505-515 | en_US |
bordeaux.volume | 3 | en_US |
bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
bordeaux.issue | 4 | en_US |
bordeaux.institution | Université de Bordeaux | en_US |
bordeaux.peerReviewed | oui | en_US |
bordeaux.inpress | non | en_US |
hal.export | false | |
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