OBJECTIVES : We evaluated the effectiveness and costs of single-tablet regimens (STR) containing tenofovir, lamivudine, efavirenz and multiple-tablet regimens (MTR) with the same or different components in people initiating Highly Active Antiretroviral Therapy (HAART).

METHODS : Non-concurrent prospective cohort of 440 patients who started HAART between Jan/14 and Dec/15 at a referral service in Belo Horizonte, Brazil. Effectiveness was defined as viral load (VL) <50 copies/ml and evaluated after six and twelve months of treatment. Cost of HAART was calculated considering the unit purchase price by the Ministry of Health and the sum of the costs of each dispensation during one year of follow-up. Costs of drugs were originally calculated in the national currency (Brazilian real [BRL]) and converted to US dollars using the 2016 purchasing power parity conversion factor according to the World Bank (1 USD = 1.99 BRL).

RESULTS : Most patients started MTR, 189 the same combination (MTR-SC) and 66 other combinations (MTR-Other). Median age was 36 years old and 74% was male. Overall effectiveness at six months was 74.6%, being higher among patients who used STR (80.6%) compared to MTR-SC (70.3%, p=0.04) or MTR-Other (70.6%, p=0.14). At twelve months, 83.2% of patients reached viral suppression, with no differences between groups. Median time on HAART was comparable: 330 days for STR, 360 for MTR-SC and 345 for MTR-Other (p>0.05). Mean annual cost of treatment per patient was lower for STR, $111.88±3.06 compared to $609.59±12.63 for MTR-SC and $809.57±12.63 for MTR-Other.

CONCLUSIONS : Viral suppression at six and twelve months was high. Although other direct costs of health should be considered to compare groups, STR seems to be more effective and less costly than other HAART regimens in the Brazilian context.