OBJECTIVES: Current antiretroviral therapy (ART) has improved health outcomes for people living with HIV (PLHIV) but requires daily oral administration, making adherence to treatment a challenge for some. CAB+RPV LA, administered by a healthcare professional via intramuscular injection every 2 months (Q2M), is the first complete LA regimen for the maintenance treatment of HIV. The objective of this analysis was to evaluate the cost-effectiveness of CAB+RPV LA Q2M, prescribed in line with its licence, compared with standard of care (SoC) in Austria.

METHODS: A previously published Markov-cohort-state-transition model was adapted to the Austrian healthcare setting and populated with data from the Phase III/IIIb studies of CAB+RPV LA (pooled ATLAS and FLAIR, ATLAS-2M). The health states included were based on therapy-lines, virological response, CD4 cell-count, and death. The model contained a maximum of four ARV therapy lines. Direct costs (interventions and injectable administration costs, 2021€) were derived from published sources. A utility advantage of 0.02 was applied for LA treatment based on a post-hoc analysis of health-related QoL data from ATLAS and FLAIR. A reduction in adherence rate of 25.6% was assumed for SoC. Benefits were measured in quality-adjusted life-years (QALYs) and life-years (LYs). A lifetime horizon was used and benefits and costs were discounted (3%), annually. Parameters were explored in sensitivity analyses.

RESULTS: Average lifetime cost per patient in the CAB+RPV LA Q2M group was €285,881, whilst for those receiving SoC was €295,705. Prescribing CAB+RPV LA Q2M was associated with €9,825 cost saving. CAB+RPV LA Q2M generated 13.08 QALYs versus 12.60 QALYs for SoC. In the base case analysis, CAB+RPV LA Q2M was the dominant treatment. Results were robust to sensitivity analyses.

CONCLUSIONS: CAB+RPV LA Q2M is associated with improvement in QALYs and lower overall costs compared with SoC and thus could generate savings in the Austrian healthcare-system.