Cost-Effectiveness of Maraviroc for Antiretroviral Treatment-Experienced HIV-infected Individuals in Mexico

Dec 1, 2010, 00:00
10.1111/j.1524-4733.2010.00798.x
https://www.valueinhealthjournal.com/article/S1098-3015(11)71822-8/fulltext
Title : Cost-Effectiveness of Maraviroc for Antiretroviral Treatment-Experienced HIV-infected Individuals in Mexico
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(11)71822-8&doi=10.1111/j.1524-4733.2010.00798.x
First page :
Section Title :
Open access? : No
Section Order : 12

Objective

Maraviroc is the first approved drug in a new class of antiretrovirals, the CCR5 antagonists. The objective of this study was to predict the long-term clinical impact and cost-effectiveness of maraviroc in treatment-experienced adults with HIV/AIDS in Mexico.

Methods

The AntiRetroviral Analysis by Monte Carlo Individual Simulation (ARAMIS) model was adapted to the Mexican context to predict clinical and economic outcomes of treating with optimized background therapy (OBT) versus testing for viral tropism status and treating with OBT ± maraviroc accordingly in treatment-experienced adults in Mexico. Baseline characteristics and efficacy were from the MOTIVATE trials' screening cohort. Costs and population mortality data were specific to Mexico. Results were reported from the perspective of health care payers in 2008 Mexican pesos (converted to 2008 US$ in parentheses).

Results

Compared to treatment with OBT alone, treatment with OBT ± maraviroc contingent on tropism test result increased projected undiscounted life expectancy and discounted quality-adjusted life expectancy from 7.54 to 8.71 years and 4.42 to 4.92 quality-adjusted life years (QALYs), respectively, at an incremental cost of $228,215 (US$21,329). The resultant incremental cost-effectiveness ratio (ICER) was $453,978 (US$42,429) per QALY gained. The ICER was somewhat lower when maraviroc was modeled in individuals susceptible to ≤2 components of OBT ($407,329; US$38,069), while the ICER was higher in individuals susceptible to ≥3 OBT components ($718,718; US$67,171).

Conclusion

In treatment-experienced individuals with HIV/AIDS in Mexico, maraviroc may be cost-effective, particularly in individuals with limited options for active antiretroviral therapy (ART).

Categories :
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Decision Modeling & Simulation
  • Economic Evaluation
  • Reproductive & Sexual Health
  • Specific Diseases & Conditions
  • Study Approaches
Tags :
  • AIDS
  • anti-HIV agents
  • cost-effectiveness
  • economic model
  • HIV
  • maraviroc
  • Mexico
Regions :
  • Latin America
ViH Article Tags :