CLINICOECONOMIC ANALYSIS OF THE USE OF KIVEXA IN THE FIRST-LINE ANTIRETROVIRAL THERAPY OF HIV INFECTION IN THE RUSSIAN FEDERATION


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Objective. To make a clinicoeconomic estimate of the use of a fixed-dose combination (FDC) of abacavir + lamivudine (ABC/3TC) as f irst-line triple therapy for HIV infection in patients who have not previously received antiretroviral therapy (ARVT) versus a combination of the monodrugs ABC and 3TC and a zidovudine + lamivudine (ZDV/3TC) FDC. Subjects and methods. A Microsoft Excel Solver model was used to calculate the treatment cost of one HIV-infected patient receiving ABC/3TC FDC therapy regimen versus its alternative treatment using an ABC/3TC FDC versus alternative treatment — a combination of monocomponent drugs ABC + 3TC and a ZDV/3TC FDC. The calculations were made using the standards of financial costs in the public health system of the Russian Federation in 2012. The indicators of clinical efficiency and safety were simulated using the data of randomized controlled clinical trials and their meta-analysis. Results. The ABC/3TC FDC has been shown to have clinical and economic advantages over the combination monodrugs ABC + 3TC, allowing one to save an average of 3390.6 rubles per patient over 96 weeks of therapy due to a better virologic response caused by better therapeutic compliance because of the lower frequency of drug use. The ABC/3TC FDC is a more effective and safe, even if slightly cost-effective, treatment option than the ZDV/3TC FDC. The difference in ARVT costs is 61 612.52 rubles in favor of the ZDV/3TC + EFV regimen. Eventually, when all costs are included in the calculations, however, it reduces to 45 267.05 rubles or by 26.53% due to the lower incidence of adverse reactions requiring that the treatment regimen using ABC/3TC FDC be switched and due to the better virologic response to therapy, which is caused by the lower frequency of drug use. Conclusion. The results of the clinicoeconomic study suggest that it is expedient to use the ABC/3TC FDC as a more effective, safe, and easy-to-use alternative versus the combination of the monodrugs ABC + 3TC and ZDV/3TC FDC in the first-line ARVT of HIV-infected patients in the Russian Federation.

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作者简介

Elena PYADUSHKINA

National Center for Health Technology Assessment

Email: epyadushkina@mail.ru
Moscow

N. ANDREEVA

National Center for Health Technology Assessment

Email: nat.andreyeva@gmail.com
Moscow

V. OMELYANOVSKY

Center for Health Technology Assessment, Russian Presidential Academy of National Economy and Public Administration

Email: vvo@hta-rus.ru
Moscow

M. AVXENTYEVA

Center for Health Technology Assessment, Russian Presidential Academy of National Economy and Public Administration; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: avksent@yahoo.com
Moscow

O. REBROVA

National Center for Health Technology Assessment; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: o.yu.rebrova@gmail.com
Moscow

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