Cost-effectiveness of raltegravir in HIV/AIDS

Mohammad Ashraf Chaudhary, Elamin H. Elbasha, Ritesh N. Kumar, Esther C. Nathanson

Research output: Contribution to journalArticle

Abstract

Raltegravir is a first-in-class HIV-1 integrase inhibitor with established antiviral efficacy in treatment-naive and treatment-experienced patients with multidrug-resistant HIV-1 infection. In this article, we summarize pharmacoeconomic evaluations of raltegravir-based treatment regimens, compared with alternative therapies, in the treatment of patients with HIV infection and/or AIDS. Cost-effectiveness evaluations of raltegravir in treatment-experienced patients conducted using a continuous-time, state-transition Markov cohort model suggest that raltegravir, combined with optimized background therapy, falls within the range that would generally be considered cost effective compared with optimized therapy alone in Spanish, Swiss and UK health systems. In treatment-naive populations, raltegravir was evaluated using a three-stage continuous-time state-transition cohort model. Raltegravir-based initiation treatment strategies (first-line raltegravir) were compared with protease inhibitor and non-nucleoside reverse-transcriptase inhibitor initiation strategies, in which raltegravir was retained for salvage therapy. First-line raltegravir was cost-effective versus retaining raltegravir for salvage therapy in several European populations. A separate economic model was used to evaluate first-line raltegravir against two alternative initiation regimens representing standard clinical practice in Australia; raltegravir proved to be cost effective in both scenarios. In all studies examined, results were sensitive to factors including treatment duration, mortality rate, analytic time horizon, health utility weights, cost of raltegravir and optimized therapy, incidence of opportunistic infection and discount rates. Nonetheless, raltegravir remained cost effective under most scenarios.

Original languageEnglish (US)
Pages (from-to)627-639
Number of pages13
JournalExpert Review of Pharmacoeconomics and Outcomes Research
Volume11
Issue number6
DOIs
StatePublished - Dec 2011
Externally publishedYes

Fingerprint

Cost-Benefit Analysis
Acquired Immunodeficiency Syndrome
HIV
Costs and Cost Analysis
Therapeutics
Salvage Therapy
Raltegravir Potassium
HIV Infections
HIV Integrase Inhibitors
Economic Models
Pharmaceutical Economics
Reverse Transcriptase Inhibitors
Opportunistic Infections
Health
Complementary Therapies
Protease Inhibitors
Population
Antiviral Agents
HIV-1
Weights and Measures

Keywords

  • cost-effectiveness
  • HIV-1
  • HIV/AIDS
  • integrase inhibitor
  • raltegravir

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Health Policy

Cite this

Chaudhary, M. A., Elbasha, E. H., Kumar, R. N., & Nathanson, E. C. (2011). Cost-effectiveness of raltegravir in HIV/AIDS. Expert Review of Pharmacoeconomics and Outcomes Research, 11(6), 627-639. https://doi.org/10.1586/erp.11.79

Cost-effectiveness of raltegravir in HIV/AIDS. / Chaudhary, Mohammad Ashraf; Elbasha, Elamin H.; Kumar, Ritesh N.; Nathanson, Esther C.

In: Expert Review of Pharmacoeconomics and Outcomes Research, Vol. 11, No. 6, 12.2011, p. 627-639.

Research output: Contribution to journalArticle

Chaudhary, MA, Elbasha, EH, Kumar, RN & Nathanson, EC 2011, 'Cost-effectiveness of raltegravir in HIV/AIDS', Expert Review of Pharmacoeconomics and Outcomes Research, vol. 11, no. 6, pp. 627-639. https://doi.org/10.1586/erp.11.79
Chaudhary, Mohammad Ashraf ; Elbasha, Elamin H. ; Kumar, Ritesh N. ; Nathanson, Esther C. / Cost-effectiveness of raltegravir in HIV/AIDS. In: Expert Review of Pharmacoeconomics and Outcomes Research. 2011 ; Vol. 11, No. 6. pp. 627-639.
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