Cost-effectiveness of adding an agent that improves immune responses to initial antiretroviral therapy (ART) in HIV-infected patients: guidance for drug development.

摘要: PURPOSE Adding an immune-enhancing agent to initial antiretroviral therapy (ART) for HIV is a potential strategy ensure that patients achieve optimal immune response. METHOD Using mathematical model of disease and treatment, we evaluated the treatment benefits cost-effectiveness adding hypothetical 6 months ART. We assumed additional would result in higher CD4 increase provide clinical benefit. The cost ($1,900/month) was based on drug currently under investigation enhancement. Outcomes included projected life expectancy 2009 US dollars/quality-adjusted year (QALY) with costs QALYs discounted at 3% annually. RESULTS Compared standard ART, immune-enhanced ART resulting 40 cell/µL yields 2.4 month undiscounted ratio $107,600/QALY. Achieving 43 improvement, or >19 cells/µL if are halved. CONCLUSIONS In addition showing efficacy, investigational enhancement agents need counts more than has been previously observed have lower be considered cost-effective United States.