A Cost-Effectiveness Evaluation for a New Therapy in HIV Treatment.

PIN77 A Cost-EffECtIvENEss EvAluAtIoN for A NEw thErAPy IN hIv trEAtmENt Malhan S.1, Kockaya G.2, Elbir Zengin T.2, Dalgic C.2, Yenilmez F.B.3, Cerci P.3, Oksuz E.1, Tayfun K.2, Unal S.3 1Baskent University, Ankara, Turkey, 2Gilead Science, Istanbul, Turkey, 3Hacettepe University, Ankara, Turkey Objectives: Economical evaluation of Stribild in Turkey, which is a single tablet regimen indicated for the treatment of HIV-1 infection in adults aged 18 years and over who are antiretroviral treatment naive or are infected with HIV-1 without known mutations associated with resistance to any of the three antiretroviral agents in it. MethOds: STRIBILDTM was compared with various treatment options; tenofovir DF+emtricitabine+efavirenz (FTC/TDF+EFV), tenofovir DF+emtricitabine+ ritonavir+lopinavir (FTC/TDF+LPV/r), tenofovirDF+emtricitabine+nevirapine (FTC/ TDF+NVP), tenofovir DF+emtricitabine+darunavir (FTC/TDF+DRV+r), tenofovir DF+emtricitabine+raltegravir (FTC/TDF+RAL), lamivudine+zidovudine+efavirenz (3TC/AZT+EFV), lamivudine+zidovudine+ritonavir+lopinavir (3TC/AZ+LPV/r), lam ivudine+zidovudine+nevirapine (3TC/AZT+NVP). The adherence rates were calculated from the increase rate in CD4 cell count and the risk of hospitalization as the effectiveness values. The data were taken from patient files from Hacettepe University that consists of 252 patients and 12 year follow-ups with an outpatient clinic, interventions, laboratory and imaging tests, medication usage, side effects, comorbidity’s diseases and their treatments and complications. The costs of treatment of diseases were calculated by cost of disease methodology. Average annual cost per patient is calculated for health care technologies. Health technology effectiveness values are found from the literature review. Incremental cost-effectiveness ratio (ICER) was used for the comparison. Results: According to comparison of rate of compliance to treatment, STRIBILDTM was cost effective against 3TC/AZT+EFV (2157.2 TL), FTC/TDF+LPV/r (612.7 TL), FTC/TDF+NVP (951.9 TL), FTC/TDF+DRV+r (544.28 TL) and cost saving aganist FTC/TDF+RAL (-166,22 TL). According to the rate of risk of hospitalization, STRIBILDTM was cost effective against 3TC/AZT+EFV (517.7 TL), FTC/TDF+LPV/r (318.6 TL), FTC/TDF+NVP (495 TL), FTC/TDF+DRV+r (283 TL), 3TC/ AZT+EFV (632,4 TL), 3TC/AZ+LPV/r (425.6 TL), 3TC/AZT+NVP (591.2 TL). According to the increase rate in CD4 cell count and over 95% of compliance rate, STRIBILDTM was cost effective against FTC/TDF+EFV (392.2 TL) and cost saving against FTC/TDF+RAL (-308.7 TL), respectively. cOnclusiOns: HIV is a life-threatening disease with in terms of major public health problem globally.. In this study, STRs in comparison of combination treatment strategies, has higher compliance rates, better outcomes and lower health care costs.