TY - JOUR
T1 - Budget impact analysis of the simplification to atazanavir + ritonavir + lamivudine dual therapy of HIV-positive patients receiving atazanavir-based triple therapies in Italy starting from data of the Atlas-M trial
AU - Restelli, Umberto
AU - Fabbiani, Massimiliano
AU - Di Giambenedetto, Simona
AU - Nappi, Carmela
AU - Croce, Davide
PY - 2017
Y1 - 2017
N2 - Background: This analysis aimed at evaluating the impact of a therapeutic strategy of treatment simplification of atazanavir (ATV)+ ritonavir (r) + lamivudine (3TC) in virologically suppressed patients receiving ATV+r+2 nucleoside reverse transcriptase inhibitors (NRTIs) on the budget of the Italian National Health Service (NHS). Methods: A budget impact model with a 5-year time horizon was developed based on the clinical data of Atlas-M trial at 48 weeks (in terms of percentage of patients experiencing virologic failure and adverse events), from the Italian NHS perspective. A scenario in which the simplification strategy was not considered was compared with three scenarios in which, among a target population of 1,892 patients, different simplification strategies were taken into consideration in terms of percentage of patients simplified on a yearly basis among those eligible for simplification. The costs considered were direct medical costs related to antiretroviral drugs, adverse events management, and monitoring activities. Results: The percentage of patients of the target population receiving ATV+r+3TC varies among the scenarios and is between 18.7% and 46.9% in year 1, increasing up to 56.3% and 84.4% in year 5. The antiretroviral treatment simplification strategy considered would lead to lower costs for the Italian NHS in a 5-year time horizon between -28.7 million € and -16.0 million €, with a reduction of costs between -22.1% (-3.6 million €) and -8.8% (-1.4 million €) in year 1 and up to -39.9% (-6.9 million €) and -26.6% (-4.6 million €) in year 5. Conclusion: The therapy simplification for patients receiving ATV+r+2 NRTIs to ATV+r+3TC at a national level would lead to a reduction of direct medical costs over a 5-year period for the Italian NHS.
AB - Background: This analysis aimed at evaluating the impact of a therapeutic strategy of treatment simplification of atazanavir (ATV)+ ritonavir (r) + lamivudine (3TC) in virologically suppressed patients receiving ATV+r+2 nucleoside reverse transcriptase inhibitors (NRTIs) on the budget of the Italian National Health Service (NHS). Methods: A budget impact model with a 5-year time horizon was developed based on the clinical data of Atlas-M trial at 48 weeks (in terms of percentage of patients experiencing virologic failure and adverse events), from the Italian NHS perspective. A scenario in which the simplification strategy was not considered was compared with three scenarios in which, among a target population of 1,892 patients, different simplification strategies were taken into consideration in terms of percentage of patients simplified on a yearly basis among those eligible for simplification. The costs considered were direct medical costs related to antiretroviral drugs, adverse events management, and monitoring activities. Results: The percentage of patients of the target population receiving ATV+r+3TC varies among the scenarios and is between 18.7% and 46.9% in year 1, increasing up to 56.3% and 84.4% in year 5. The antiretroviral treatment simplification strategy considered would lead to lower costs for the Italian NHS in a 5-year time horizon between -28.7 million € and -16.0 million €, with a reduction of costs between -22.1% (-3.6 million €) and -8.8% (-1.4 million €) in year 1 and up to -39.9% (-6.9 million €) and -26.6% (-4.6 million €) in year 5. Conclusion: The therapy simplification for patients receiving ATV+r+2 NRTIs to ATV+r+3TC at a national level would lead to a reduction of direct medical costs over a 5-year period for the Italian NHS.
KW - 2001
KW - Antiretroviral therapy
KW - Cost
KW - De-intensification
KW - Economic evaluation
KW - Health Policy
KW - Italian National Health Service
KW - Protease inhibitor
KW - 2001
KW - Antiretroviral therapy
KW - Cost
KW - De-intensification
KW - Economic evaluation
KW - Health Policy
KW - Italian National Health Service
KW - Protease inhibitor
UR - https://publicatt.unicatt.it/handle/10807/127177
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85015879175&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85015879175&origin=inward
U2 - 10.2147/CEOR.S127097
DO - 10.2147/CEOR.S127097
M3 - Article
SN - 1178-6981
VL - 9
SP - 173
EP - 179
JO - ClinicoEconomics and Outcomes Research
JF - ClinicoEconomics and Outcomes Research
IS - 3
ER -