BACKGROUND: DTG-based and EFV-based triple combination ARV regimen are the recognized first line therapy for the management of HIV in Nigeria. The cost effectiveness of DTG-based regimen against EFV-based regimen are yet to be known in Nigerian tertiary hospitals.

OBJECTIVES: To determine the cost-effectiveness of DTG-based regimens against EFV-based regimens at the University College Hospital, Ibadan, Nigeria.

METHODS: A retrospective study design was used in retrieving patients’ information from the database, comparing the variables using a case-control approach. A pro forma was used to collect the following variables: age, gender, state of origin, educational level, occupation, marital status, date of diagnosis, duration of disease, cost of management, first line ARVs, CD4 count test results after commencing HAART, Viral Load test results after commencing HAART. The data were entered into statistical product and services solution Version-25 for analysis. Descriptive statistical analysis (Mean, Median, Mode, Frequency, Percentages) was used to analyze the study. Incremental Cost-effectiveness Ratios was computed to compare the regimens

RESULTS: A total of 429 patients’ data were for this study. Most of the patients were on DTG-based regimen [394 (91.8%)]. DTG-based regimens had better efficacy than EFV-based regimen at all viral load benchmarks (50, ≤100, ≤150 and ≤200 copies/mL). The total cost of managing all the patients on DTG-based regimen was $31220528.48, which translated to $79,239.92 per patient while that of EFV-based regimen was $2773586.20, and $79,245.32. The incremental cost-effective ratio (ICER) of patients on DTG at VL of 50copies/mL over those on EFV was $15.70 per effectiveness in a patient.

CONCLUSIONS: DTG- based regimen is associated with a higher cost of treatment compared to EFV-based regimen and was more effective in treating HIV naïve patients. thus, switching from EFV to DTG-based regimens will lead to both increased cost and increased effectiveness.