%0 Journal Article
%T Cost-effectiveness analysis of HIV treatment in the clinical practice of a public hospital in northern Italy
%A Rizzardini G
%A Bonfanti P
%A Carenzi L
%A Coen M
%J Therapeutics and Clinical Risk Management
%D 2012
%I Dove Medical Press
%X Giuliano Rizzardini,1 Paolo Bonfanti,2 Laura Carenzi,1 Massimo Coen,1 Giovanna Orlando,1 Sergio Di Matteo,3 Giorgio L Colombo3,411st Infectious Diseases Department, ¡°L. Sacco¡± Hospital, Milan, Italy; 2Infectious Diseases Department, A Manzoni Hospital, Lecco, Italy; 3S.A.V.E. Studi Analisi Valutazioni Economiche, Milan, Italy; 4University of Pavia, Department of Drug Sciences, School of Pharmacy, ItalyIntroduction: We carried out an economic analysis to assess the cost-effectiveness of highly active antiretroviral therapy (HAART) regimens in Italy for the management of human immunodeficiency virus (HIV)-infected patients according to clinical practice in the Infectious Diseases Department of ¡°L. Sacco¡± Hospital, Milan, Italy.Patients and methods: The incremental cost-effectiveness analysis was completed by means of a Markov model. Through a decision-analytic approach, this enabled us to compare the studied antiretroviral regimens. The model considered a population of adult HIV subjects who received HAART therapy for the first time according to clinical practice in the Infectious Diseases Department of ¡°L. Sacco¡± Hospital, Milan. Data were investigated from the standpoint of the Lombardy Regional Health Service. We considered the following outcome measures: quality-adjusted life-years (QALYs), and direct health costs calculated for the years 2008 and 2009. The time horizon adopted in the model was 2 years.Results: The model revealed that, in terms of cost per gained QALY, the tenofovir disoproxil fumarate + emtricitabine + efavirenz (TDF+FTC+EFV) once-a-day treatment strategy seems to be the most cost-effective therapeutic choice (?34,965); the incremental cost-effectiveness ratio (ICER) values for the remaining strategies ranged from ?53,000 to around ?62,000 per QALY. The validity of the base case scenario was then confirmed by means of a sensitivity analysis on the main variables.Conclusion: The TDF+FTC+EFV treatment strategy (TDF/FTC+EFV fixed-dose combination then switched to single-tablet regimen [STR]) in this setting is the most cost-effective treatment strategy compared with the other therapeutic regimens. The ICER value for the TDF+FTC+EFV once-a-day then switched to STR treatment was lower than the internationally generally accepted threshold value of ?50,000. The developed model is a tool for policy makers and health care professionals for creating short- and long-term cost projections, with the aim of assessing their impact on the available budgets for HIV patients.Keywords: AIDS, HIV, HAART antiretroviral therapy regimens, single-tablet reg
%U http://www.dovepress.com/cost-effectiveness-analysis-of-hiv-treatment-in-the-clinical-practice--a11013