Abstract:
:Raltegravir, a novel HIV-1 integrase inhibitor, has superior efficacy with optimized background treatment (OBT) vs. placebo + OBT in treatment-experienced HIV-1 patients. This study assessed the long-term cost effectiveness of raltegravir from a Spanish National Healthcare System perspective. A cohort-state-transition model was used to estimate clinical and economic outcomes associated with raltegravir + OBT vs. OBT alone. Subjects were stratified into health states according to HIV RNA level, CD4 count, and opportunistic infection (OI) history, and could transition into different health states over time based on projected long-term efficacy. Each health state was associated with a distinct treatment cost and utility (QoL) score. Model inputs for mortality, resource utilization, unit costs, OI risk, and long-term durability of viral suppression were obtained from clinical trials, published studies, and database analyses. Model outcomes were reported as incremental cost-effectiveness ratios (ICERs) in 2007 Euros per quality-adjusted life-year (euro/QALY) gained. Costs and QALYs were discounted at 6% per year based on Spanish cost-effectiveness guidelines. Extensive sensitivity analyses were conducted. Five years of treatment with raltegravir + OBT resulted in an additional 4.5 years of undiscounted life expectancy vs. OBT alone. The ICER of raltegravir + OBT vs. OBT alone was euro22,908/QALY and euro31,431/QALY for 3- and 5-year use, respectively. Lower ICERs were observed with lower discount rates (3%) for costs and benefits, lower raltegravir price (20%), and shorter treatment duration (3 years). ICER was also sensitive to analytical time horizon and alternative sources of QoL scores. In treatment-experienced Spanish patients, raltegravir was projected to provide survival benefits and be cost effective.
journal_name
AIDS Res Hum Retrovirusesjournal_title
AIDS research and human retrovirusesauthors
Chaudhary MA,Moreno S,Kumar RN,Nocea G,Elbasha Edoi
10.1089/aid.2008.0254subject
Has Abstractpub_date
2009-07-01 00:00:00pages
679-89issue
7eissn
0889-2229issn
1931-8405journal_volume
25pub_type
杂志文章abstract::The pharmacokinetics and short-term safety of atazanavir 150 and 200 mg, when coadministered with saquinavir/ritonavir 1600/100 mg once daily, were evaluated. On day 1, atazanavir 150 mg once daily, was added to saquinavir/ritonavir regimens and sampling was performed to evaluate saquinavir, ritonavir, and atazanavir ...
journal_title:AIDS research and human retroviruses
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journal_title:AIDS research and human retroviruses
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journal_title:AIDS research and human retroviruses
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/088922200309539
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/AID.2019.0098
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.1989.5.279
更新日期:1989-06-01 00:00:00
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/AID.2011.0264
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.2006.22.854
更新日期:2006-09-01 00:00:00
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章,多中心研究
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更新日期:2017-03-01 00:00:00
abstract::HIV-1 subtype B isolates have previously been described in India only in the state of Andhra Pradesh, while subtype C isolates have been reported as widespread in the Bombay and Goa regions of India. Gag subtype was determined in HIV-1 isolates from six Indians and one Ethiopian. One Indian was a native of Goa resid...
journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.1996.12.641
更新日期:1996-05-01 00:00:00
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章,多中心研究
doi:10.1089/aid.1998.14.685
更新日期:1998-05-20 00:00:00
abstract::The use of ritonavir as a protease inhibitor boost is rare in sub-Saharan Africa because a heat-stable formula is not available. We report the results of an open-label pilot trial with unboosted atazanavir in combination with lamivudine and didanosine as first-line therapy conducted in Senegal. Treatment-naive HIV-1 i...
journal_title:AIDS research and human retroviruses
pub_type: 临床试验,杂志文章
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更新日期:2010-05-01 00:00:00
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/AID.2013.0099
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.1990.6.1125
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.2006.0260
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.1989.5.107
更新日期:1989-02-01 00:00:00
abstract::During a 6-month period, we studied the diversity of HIV-1 subtypes in 392 adult patients seen in Bichat-Claude Bernard Hospital, northern Paris, France. All the samples were serotyped and a subset was genotyped by means of HMA. Serotyping was performed with a new peptide subtype-specific EIA (SSEIA), based on in vitr...
journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.1996.12.1427
更新日期:1996-10-10 00:00:00
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.1996.12.1161
更新日期:1996-08-10 00:00:00
abstract::HIV-1 infection evokes a vigorous antiviral response that may participate in resolving the initial peak of plasma viremia and maintenance of the asymptomatic state. CD8+ T lymphocytes of HIV-1-infected individuals play a critical role in the cellular anti-HIV response. In agreement with previous reports, we observed a...
journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.1993.9.1079
更新日期:1993-11-01 00:00:00
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.2007.0056
更新日期:2007-09-01 00:00:00
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.2008.0049
更新日期:2008-08-01 00:00:00
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journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/AID.2015.0105
更新日期:2015-08-01 00:00:00
abstract::The membrane glycolipids galactosylceramide (GalCer) and sulfatide (SGalCer) have been reported to act as receptors of human immunodeficiency virus (HIV) on CD4- cell lines. We show here that these glycolipids are present on CD4+ cells purified from human blood and on in vitro-differentiated monocyte-derived macrophag...
journal_title:AIDS research and human retroviruses
pub_type: 杂志文章
doi:10.1089/aid.1996.12.695
更新日期:1996-05-20 00:00:00