In 2014, a head-to-head clinical trial compared the 96-week efficacy and tolerability of three HIV multi-drug combinations commonly used as initial treatment for individuals with HIV-1 infection. The study found raltegravir (RAL) to be superior to atazanavir plus ritonavir (ATV/r) and darunavir plus ritonavir (DRV/r) when used in combination with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF). This research did not, however, address the costs associated with each treatment regimen.
RTI Health Solutions Health Economists Anita Brogan and Ashley Davis were coauthors on a new study to estimate the total HIV treatment costs associated with these three antiretroviral combinations in the United States.
The researchers developed an economic model based on the clinical outcomes provided by the clinical trial and tracked costs incurred over time, including antiretroviral drug costs, adverse event management costs, and HIV care costs. Total 96-week treatment costs and the percentage of patients successfully treated (i.e., remained on first-line treatment in the clinical trial for 96 weeks) were estimated in the base-case analysis for each first-line regimen.
RAL was associated with lower antiretroviral drug costs, lower adverse event costs, similar HIV care costs, and lower total costs ($81,231) compared with either ATV/r ($88,064) or DRV/r ($87,680). When benchmarking against the primary endpoint of the clinical trial, more individuals treated with RAL were successfully treated (91.4%), compared with individuals treated with ATV/r (75.9%) or DRV/r (83.4%).