PubTransformer

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PMID- 29384848
OWN - NLM
STAT- MEDLINE
DCOM- 20180213
LR  - 20180213
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 5
DP  - 2018 Feb
TI  - Economic evaluation of weekends-off antiretroviral therapy for young people in 11
      countries.
PG  - e9698
LID - 10.1097/MD.0000000000009698 [doi]
AB  - OBJECTIVES: To analyze the cost effectiveness of short-cycle therapy (SCT), where
      patients take antiretroviral (ARV) drugs 5 consecutive days a week and have 2
      days off, as an alternative to continuous ARV therapy for young people infected
      with human immunodeficiency virus (HIV) and taking efavirenz-based first-line ARV
      drugs. METHODS: We conduct a hierarchical cost-effectiveness analysis based on
      data on clinical outcomes and resource use from the BREATHER trial. BREATHER is a
      randomized trial investigating the effectiveness of SCT and continuous therapy in
      199 participants aged 8 to 24 years and taking efavirenz-based first-line ARV
      drugs in 11 countries worldwide. Alongside nationally representative unit
      costs/prices, these data were used to estimate costs and quality adjusted life
      years (QALYs). An incremental cost-effectiveness comparison was performed using a
      multilevel bivariate regression approach for total costs and QALYs. Further
      analyses explored cost-effectiveness in low- and middle-income countries with
      access to low-cost generic ARV drugs and high-income countries purchasing branded
      ARV drugs, respectively. RESULTS: At 48 weeks, SCT offered significant total cost
      savings over continuous therapy of US dollar (USD) 41 per patient in countries
      using generic drugs and USD 4346 per patient in countries using branded ARV
      drugs, while accruing nonsignificant total health benefits of 0.008 and 0.009
      QALYs, respectively. Cost-effectiveness estimates were similar across settings
      with access to generic ARV drugs but showed significant variation among
      high-income countries where branded ARV drugs are purchased. CONCLUSION: SCT is a
      cost-effective treatment alternative to continuous therapy for young people
      infected with HIV in countries where viral load monitoring is available.
FAU - Tierrablanca, Luis Enrique
AU  - Tierrablanca LE
AD  - Tecnologia e Informacion para la Salud, Mexico City, Mexico.
FAU - Ochalek, Jessica
AU  - Ochalek J
AD  - Centre for Health Economics, University of York, York.
FAU - Ford, Deborah
AU  - Ford D
AD  - Medical Research Council Clinical Trials Unit, University College London, London.
FAU - Babiker, Ab
AU  - Babiker A
AD  - Medical Research Council Clinical Trials Unit, University College London, London.
FAU - Gibb, Diana
AU  - Gibb D
AD  - Medical Research Council Clinical Trials Unit, University College London, London.
FAU - Butler, Karina
AU  - Butler K
AD  - Our Lady's Children's Hospital, Dublin.
FAU - Turkova, Anna
AU  - Turkova A
AD  - Medical Research Council Clinical Trials Unit, University College London, London.
AD  - Great Ormond Street Hospital, London, UK.
FAU - Griffin, Susan
AU  - Griffin S
AD  - Centre for Health Economics, University of York, York.
FAU - Revill, Paul
AU  - Revill P
AD  - Centre for Health Economics, University of York, York.
CN  - BREATHER (PENTA 16) Trial Group
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Benzoxazines)
RN  - 0 (Drugs, Generic)
RN  - JE6H2O27P8 (efavirenz)
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Anti-HIV Agents/*administration & dosage/*economics
MH  - Benzoxazines/administration & dosage/economics
MH  - Child
MH  - *Cost-Benefit Analysis
MH  - Drug Administration Schedule
MH  - Drugs, Generic/administration & dosage/economics
MH  - Follow-Up Studies
MH  - HIV Infections/*drug therapy/*economics
MH  - Health Care Costs
MH  - Humans
MH  - Internationality
MH  - Quality-Adjusted Life Years
MH  - Regression Analysis
MH  - Treatment Outcome
MH  - Viral Load
MH  - Young Adult
EDAT- 2018/02/01 06:00
MHDA- 2018/02/14 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/14 06:00 [medline]
AID - 10.1097/MD.0000000000009698 [doi]
AID - 00005792-201802020-00010 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(5):e9698. doi: 10.1097/MD.0000000000009698.