Cost-Effectiveness of Early Treatment with First-Line NNRTI-Based HAART Regimens in the UK, 1996-2006
2011

Cost-Effectiveness of Early HIV Treatment in the UK

Sample size: 5541 publication 10 minutes Evidence: high

Author Information

Author(s): Beck Eduard J., Mandalia Sundhiya, Lo Gary, Sharott Peter, Youle Mike, Anderson Jane, Baily Guy, Brettle Ray, Fisher Martin, Gompels Mark, Kinghorn George, Johnson Margaret, McCarron Brendan, Pozniak Anton, Tang Alan, Walsh John, White David, Williams Ian, Gazzard Brian

Primary Institution: NPMS-HHC Coordinating and Analytic Centre, London, United Kingdom

Hypothesis

Is the cost-effectiveness of NNRTI-based HAART regimens better than PI-boosted regimens for HIV treatment in the UK from 1996 to 2006?

Conclusion

Starting HIV treatment with NNRTI-based regimens is more cost-effective than PI-boosted regimens, especially for patients with lower CD4 counts.

Supporting Evidence

  • 55% of people living with HIV started HAART with CD4 count ≤200 cells/mm3.
  • 2NRTI+NNRTI regimens were cost-saving or cost-effective compared to 2NRTI+PIboosted regimens.
  • Annual treatment costs decreased as CD4 count increased.
  • 18% of participants failed first-line HAART during the study period.
  • Women and younger individuals were more likely to fail first-line therapy.

Takeaway

This study found that giving HIV patients certain medications earlier can save money and help them stay healthier.

Methodology

The study analyzed data from 14 UK hospitals on treatment outcomes and costs for HIV patients starting HAART between 1996 and 2006.

Potential Biases

Potential residual confounding due to observational data.

Limitations

The study was limited by the exclusion of patients with missing CD4 counts and the majority of data coming from London hospitals.

Participant Demographics

73% of participants were men, 59% Caucasian, and 22% Black African.

Statistical Information

P-Value

0.002

Confidence Interval

95% CI 0.32 to 0.78

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0020200

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