PHARMACOECONOMICAL ANALYSIS OF ANTIRETROVIRAL THERAPY IN PATIENTS WITH HIV AND HEPATITIS B VIRUS CO-INFECTION


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Abstract

Among HIV-positive patients, there are 10-15% cases of chronic hepatitis B virus (HBV) co-infection. This necessitates the choice of an optimal therapy regimen for both infections. Objective. To study the cost-effectiveness of drugs recommended for first-line antiretroviral therapy (ART) in HIV/HBV co-infected patients previously untreated with a fixed-dose combination (FDC) of TDF/FTC versus that of ABC/3TC and AZT/3TC. Subjects and methods. The pharmacoeconomical study was conducted using the simulation method to calculate direct medical costs. The model used the results of a study by L.M. Pawlotsky et al. reporting rates of HBV resistance to 3TC and TDF in a five-year time horizon. The risk of 3TC resistance progressively increases over time by achieving 70% at year 5 of treatment while that TDF resistance remains at zero throughout the therapy period. Results. The calculations in the model have indicated that the use of 3TC-containing FDCs in the five-year time horizon costs 53 400 rubles (or 7%) more than the baseline administration of TDF/FTC because of the development of HBV resistance and of the need for additional use of entecavir. Conclusion. The use of a FDC of TDF/FTC for first-line ART in previously untreated patients is economically sound in treating HIV/HBV co-infected patients in Russian clinical practice.

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About the authors

Galina M. KOZHEVNIKOVA

Peoples' Friendship University of Russia

Email: gmk10@mail.ru
Moscow

O. S EFREMOVA

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare

Email: ks517@yandex.ru
Moscow

ABDURAHMAN. JALLOLU

Peoples' Friendship University of Russia

Email: gmk10@mail.ru
Moscow

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