TY - JOUR
T1 - Health technology assessment in the HIV setting
T2 - The case of monotherapy
AU - Restelli, Umberto
AU - Croce, Davide
AU - Porazzi, Emanuele
AU - Scolari, Francesca
AU - Bonfanti, Marzia
AU - Galli, Massimo
AU - Gianotti, Nicola
AU - Rizzardini, Giuliano
AU - Garagiola, Elisabetta
AU - Vanzago, Anna
AU - Foglia, Emanuela
PY - 2014
Y1 - 2014
N2 - Despite the success of multiple-drug therapy regimens, the idea of treating human immunodeficiency virus (HIV) infection with fewer drugs is captivating due to issues of convenience, long-term toxicities and costs. This study investigated the impact on a local health budget of the introduction of a protease inhibitor (PI)-based antiretroviral monotherapy. An analysis of 23,721 administrative records of HIV-infected patients and a health technology assessment (HTA) were performed to assess cost-effectiveness, budget, organizational, ethics, and equity impact. Data showed that monotherapy had a annual cost of 7,076 (patient with undetectable viral load) and 7,860 (patient with detectable viral load), and that its implementation would realise economic savings of between 12 and 24 million euro (between 4.80% and 9.72% of the 2010 total regional budget expenditure for HIV management) in the first year, with cumulated savings of between 48 and 145 million euro over the following five years. Organizational, ethical and equity impact did not indicate any significant differences. The study suggests that for specific categories of patients monotherapy may be an alternative to existing therapies. Its implementation would not result in higher operating costs, and would lead to a reduction in total expenditure.
AB - Despite the success of multiple-drug therapy regimens, the idea of treating human immunodeficiency virus (HIV) infection with fewer drugs is captivating due to issues of convenience, long-term toxicities and costs. This study investigated the impact on a local health budget of the introduction of a protease inhibitor (PI)-based antiretroviral monotherapy. An analysis of 23,721 administrative records of HIV-infected patients and a health technology assessment (HTA) were performed to assess cost-effectiveness, budget, organizational, ethics, and equity impact. Data showed that monotherapy had a annual cost of 7,076 (patient with undetectable viral load) and 7,860 (patient with detectable viral load), and that its implementation would realise economic savings of between 12 and 24 million euro (between 4.80% and 9.72% of the 2010 total regional budget expenditure for HIV management) in the first year, with cumulated savings of between 48 and 145 million euro over the following five years. Organizational, ethical and equity impact did not indicate any significant differences. The study suggests that for specific categories of patients monotherapy may be an alternative to existing therapies. Its implementation would not result in higher operating costs, and would lead to a reduction in total expenditure.
KW - Budget impact analysis
KW - Health technology assessment
KW - PI-based monotherapy
KW - Standard therapies
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M3 - Article
C2 - 25180841
AN - SCOPUS:84906484382
VL - 37
SP - 247
EP - 261
JO - New Microbiologica
JF - New Microbiologica
SN - 1121-7138
IS - 3
ER -