Lower Healthcare Costs Associated with the Use of a Single-Pill ARV Regimen in the UK, 2004–2008

Investigate the cost and effects of a single-pill versus two- or three pill first-line antiretroviral combinations in reducing viral load, increasing CD4 counts, and first-line failure rate associated with respective regimens at 6 and 12 months. Patients on first-line TDF+3TC+EFV, TDF+FTC+EFV, Truva...

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Vydané v:	PloS one Ročník 7; číslo 10; s. e47376
Hlavní autori:	Beck, Eduard J., Mandalia, Sundhiya, Sangha, Roshni, Youle, Mike, Brettle, Ray, Gompels, Mark, Johnson, Margaret, Pozniak, Anton, Schwenk, Achim, Taylor, Stephen, Walsh, John, Wilkins, Ed, Williams, Ian, Gazzard, Brian
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Public Library of Science 30.10.2012 Public Library of Science (PLoS)
Predmet:	Acquired immune deficiency syndrome Adenine - administration & dosage Adenine - analogs & derivatives Adult AIDS Analysis Anti-Retroviral Agents - administration & dosage Antiretroviral agents Antiretroviral drugs Biology CD4 antigen CD4 Lymphocyte Count Cost analysis Costs Deoxycytidine - administration & dosage Deoxycytidine - analogs & derivatives Drug Combinations Drug dosages Drug resistance Drug therapy Drugs Economic aspects Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination Failure Female Health care Health Care Costs Highly active antiretroviral therapy HIV HIV Infections - drug therapy HIV Infections - economics HIV Infections - pathology Human immunodeficiency virus Humans Induction therapy Licenses Load distribution Male Medical diagnosis Medical screening Medicine Middle Aged Organophosphonates - administration & dosage Organophosphorus Compounds - administration & dosage Oxazines - administration & dosage Patients Proportional Hazards Models Regression analysis Social and Behavioral Sciences Statistical analysis United Kingdom Viral Load
ISSN:	1932-6203, 1932-6203
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Shrnutí:	Investigate the cost and effects of a single-pill versus two- or three pill first-line antiretroviral combinations in reducing viral load, increasing CD4 counts, and first-line failure rate associated with respective regimens at 6 and 12 months. Patients on first-line TDF+3TC+EFV, TDF+FTC+EFV, Truvada®+EFV or Atripla® between 1996-2008 were identified and viral load and CD4 counts measured at baseline, six and twelve months respectively. Factors that independently predicted treatment failure at six and twelve months were derived using multivariate Cox's proportional hazard regression analyses. Use and cost of hospital services were calculated at six and twelve months respectively. All regimens reduced viral load to below the limit of detection and CD4 counts increased to similar levels at six and twelve months for all treatment regimens. No statistically significant differences were observed for rate of treatment failure at six and twelve months. People on Atripla® generated lower healthcare costs for non-AIDS patients at £5,340 (£5,254 to £5,426) per patient-semester and £9,821 (£9,719 to £9,924) per patient-year that was £1,344 (95%CI £1,222 to £1,465) less per patient-semester and £1,954 (95%CI £1,801 to £2,107) less per patient-year compared with Truvada®+EFV; healthcare costs for AIDS patients were similar across all regimens. The single pill regimen is as effective as the two- and three-pill regimens of the same drugs, but if started as first-line induction therapy there would be a 20% savings on healthcare costs at six and 17% of costs at twelve months compared with Truvada®+EFV, that generated the next lowest costs.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have read the journal's policy and have the following conflicts: This study was financially supported through a non-restrictive grant from Gilead. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors. Conceived and designed the experiments: EJB SM MY BG. Performed the experiments: RS RB MG MJ AP AS ST JW EW IW. Analyzed the data: EJB SM RS. Contributed reagents/materials/analysis tools: MY RB MG MJ AP AS ST JW EW BG. Wrote the paper: EJB SM RS. Reviewed manuscript and provided comments: MY RB MG MJ AP AS ST JW EW IW BG.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0047376