DISUTILITIES ASSOCIATED WITH CENTRAL NERVOUS SYSTEM (CNS) SIDE EFFECTS OF ANTIRETROVIRAL THERAPY (ART) IN HIV

Author(s)

Gallop K1, Acaster S1, Nafees B2, Rogatto F3, Reilly G3, Perard R3
1Acaster Consulting Ltd, London, UK, 2Nafees Consulting, London, UK, 3Gilead Sciences Europe Ltd, Uxbridge, UK

OBJECTIVES: The introduction of effective ART in HIV has led to substantial reductions in morbidity and mortality. However adverse events (AEs) associated with ARTs can lead to discontinuation, and worsening of health-related quality of life (HRQL). This study aimed to elicit societal disutility values for CNS side effects associated with ARTs in France.  METHODS: Health states (HS) were developed from interviews with HIV patients (N=9) and one specialist clinician in France. HS were developed to describe a stable HIV health state (on treatment), and nine CNS side effects associated with ARTs (abnormal dreams, insomnia, anxiety and depression, suicidal thoughts, balance and coordination problems, attention difficulties, dizziness, headaches and somnolence). Draft HS were reviewed and refined in interviews with patients and clinicians (N=4 in total). The revised HS were piloted with general public to check understanding and then evaluated by 100 members of the public in France using the time trade-off method.  RESULTS: The sample (N=100) demographics were representative of the general population of France by age, gender and education level. The stable HS had a utility value of 0.95. The disutility of the CNS side effects ranged from -0.09 (abnormal dreams) to -0.62 (suicidal thoughts) from the stable state. The disutility values for the other side effects were: -0.11 (headaches), -0.12 (attention difficulties, insomnia), -0.18 (somnolence), -0.19 (dizziness), -0.25 (balance and coordination problems) and -0.37 (anxiety and depression).  CONCLUSIONS: The results suggest CNS side effects cause significant burden and impact on HRQL. Society places particular value in avoiding AEs such as suicidal thoughts, anxiety and depression and balance and coordination problems. These utility values highlight the negative impact of AEs and can be used in economic evaluations.

Conference/Value in Health Info

2015-11, ISPOR Europe 2015, Milan, Italy

Value in Health, Vol. 18, No. 7 (November 2015)

Code

PIN85

Topic

Patient-Centered Research

Topic Subcategory

Health State Utilities

Disease

Infectious Disease (non-vaccine)

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