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13th Annual Conference of the British HIV Association29 March–1 April 2007, Brighton, UK |
ANALYSIS OF UK COSTS OF PATIENT CARE VERSUS ANTIRETROVIRAL TREATMENT IN THE POWER 1 AND 2 TRIALS
HIV Med 2007; 8(Suppl. 1):13 (abstract no. P15)
Andrew Hill1, Bernard Wilson2 and Lindsay Hemmett2
1Tibotec, Mechelen, Belgium, 2Tibotec, Saunderton, UK
BACKGROUND: HIV-infected people with low CD4 counts are at higher risk of AIDS, and incur increased healthcare costs from inpatient stays and medications. By raising the CD4 count, new antiretrovirals (ARV) could save overall healthcare costs.
METHODS: In the POWER 1 and 2 trials, patients were treated with optimized NRTIs and optional T-20, plus darunavir/ritonavir (DRV/r) or control PI. Baseline CD4 counts were well balanced between the arms. By Week 48, CD4 rose by 102 cells/µl for the DRV/r arm, versus 19 cells/µl for control PI. UK data on costs of care by CD4 count and costs per AIDS event, were combined with the 48 week POWER data on CD4 counts to calculate the expected cost of healthcare in the two treatment groups.
RESULTS: The mean annual UK cost of care (excluding ARV) was £21,684, £12,160, £5,356 and £5,322, for patients with CD4 <50, 50–200 and 200–350 and >350 cells/µl respectively. In the POWER trials, at week 48, the proportions of patients with CD4 counts in these categories were 7%, 36%, 29% and 27% for the DRV/r 600/100 mg arm, versus 23%, 28%, 27% and 22% for the control PI arm. After adjusting for the greater rises in CD4 count in the DRV/r arm relative to control PI, the mean annual per-patient cost of care was predicted to be £9,473 for the DRV/r arm and £11,113 for the control PI arm, an annual saving of £1,640 per patient. The mean annual cost of antiretroviral treatment was £18,249 for the DRV/r arm versus £16,757 per patient for the control PI arm. Combining costs of patient care and antiretroviral treatment, total per-patient costs in the DRV/r arm were £27,722, versus £27,870 for the control PI arm.
CONCLUSIONS: By raising CD4 counts DRV/r treatment is predicted to lower patient care costs for ARV experienced, HIV-infected individuals. Given the additional costs of DRV versus other control PIs used in UK, the introduction of DRV for treatment-experienced patients, is expected to have no significant net effect on the UK health budget for HIV management.
2007-03-29
P15
Copyright © 2007 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD