PIN29 ESTIMATION OF THE CLINICAL OUTCOMES AND COST-EFFECTIVENESS OF DOLUTEGRAVIR/LAMIVUDINE (DTG/3TC) AS A TEST AND TREAT (T&amp;T) ANTIRETROVIRAL (ARV) REGIMEN FOR TREATMENT-NAIVE PATIENTS WITH HIV-1 INFECTION IN THE UNITED STATES

Oglesby, Alan; Nguyen, Christopher; Jacob, Ian; Anderson, Sarah-Jane; McEwan, P.; Lopes, Sara; Ward, Tom

doi:10.1016/j.jval.2019.04.900

Cited by 1 publication

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In general, the results from this analysis are consistent with cost-minimization and cost-effectiveness studies assessing DTG/3TC [ 14 – 17 ], with the caveat that these studies preferentially considered only treatment-naive populations while this study included primarily treatment-experienced individuals. In a 2021 analysis set in the United States with a lifetime horizon, DTG/3TC resulted in cost savings versus DTG/ABC/3TC, DRV/COBI/FTC/TAF, and BIC/FTC/TAF in all simulations, and also increased quality-adjusted life-years in 87% to 88% of tested scenarios [ 16 ].…”

Section: Discussionsupporting

confidence: 80%

“…In a 2021 analysis set in the United States with a lifetime horizon, DTG/3TC resulted in cost savings versus DTG/ABC/3TC, DRV/COBI/FTC/TAF, and BIC/FTC/TAF in all simulations, and also increased quality-adjusted life-years in 87% to 88% of tested scenarios [ 16 ]. Similar results were also seen when DTG/3TC was compared with BIC/FTC/TAF and DRV/COBI/FTC/TAF in a test-and-treat model in the United States [ 17 ]; with DTG/ABC/3TC, BIC/FTC/TAF, and EVG/COBI/FTC/TAF in Canada [ 14 ]; and with DTG/ABC/3TC, BIC/FTC/TAF, and EVG/COBI/FTC/TAF in Australia [ 15 ]. In alignment with the data presented here, the primary reason for DTG/3TC cost-effectiveness in these studies was lower drug acquisition costs [ 14 – 17 ].…”

Section: Discussionsupporting

confidence: 63%

“…Similar results were also seen when DTG/3TC was compared with BIC/FTC/TAF and DRV/COBI/FTC/TAF in a test-and-treat model in the United States [ 17 ]; with DTG/ABC/3TC, BIC/FTC/TAF, and EVG/COBI/FTC/TAF in Canada [ 14 ]; and with DTG/ABC/3TC, BIC/FTC/TAF, and EVG/COBI/FTC/TAF in Australia [ 15 ]. In alignment with the data presented here, the primary reason for DTG/3TC cost-effectiveness in these studies was lower drug acquisition costs [ 14 – 17 ]. Altogether, results from these analyses and the real-world observations presented here support DTG/3TC as a highly cost-saving option with similar efficacy proven in clinical trials to alternative single-tablet 3-drug regimens.…”

Section: Discussionsupporting

confidence: 63%

See 2 more Smart Citations

Comparing Real-World Healthcare Costs Associated with Single-Tablet Regimens for HIV-1: The 2-Drug Regimen Dolutegravir/Lamivudine vs. Standard 3- or 4-Drug Regimens

Priest¹,

Germain

Laliberté

et al. 2023

Infect Dis Ther

View full text Add to dashboard Cite

Introduction Dolutegravir/lamivudine (DTG/3TC) is a 2-drug regimen for HIV-1 treatment with long-term efficacy and good tolerability comparable to 3- or 4-drug regimens. This study evaluated DTG/3TC cost versus other standard single-tablet regimens during its first year of approval. Methods This retrospective study analyzed US claims data from adults with HIV-1. Eligibility criteria included ≥ 1 dispensing of DTG/3TC, DTG/abacavir (ABC)/3TC, bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF), elvitegravir (EVG)/cobicistat (COBI)/FTC/TAF, and darunavir (DRV)/COBI/FTC/TAF (index date was first dispensing) and ≥ 6 months of continuous eligibility before index date (baseline period). All-cause and HIV-related healthcare costs were evaluated during the observation period (index date until earliest of end of continuous eligibility or data availability). Adjusted cost differences and adjusted cost ratios were estimated using multivariable regression models controlling for differences in baseline characteristics between cohorts. Results Overall, 22,061 individuals with HIV-1 and dispensed treatment with DTG/3TC ( n = 590), DTG/ABC/3TC ( n = 4355), BIC/FTC/TAF ( n = 9068), EVG/COBI/FTC/TAF ( n = 7081), or DRV/COBI/FTC/TAF ( n = 967) were included. Most claims data were from men (mean age ~ 46 years). Mean unadjusted all-cause total healthcare costs per patient per month were significantly lower for DTG/3TC versus BIC/FTC/TAF and DRV/COBI/FTC/TAF, and mean unadjusted HIV-related healthcare costs per patient per month were significantly lower for DTG/3TC versus DRV/COBI/FTC/TAF. Cost differences were primarily driven by significantly lower pharmacy costs for DTG/3TC versus other regimens ( P < 0.001), while medical costs were similar across cohorts. Results were similar among treatment-naive and treatment-experienced individuals. After adjusting for baseline covariates, significant adjusted cost differences were generally consistent with unadjusted findings. Adjusted cost ratios generally favored DTG/3TC for all-cause healthcare and HIV-related costs, with all pharmacy cost ratios favoring DTG/3TC ( P < 0.001). Conclusion Dolutegravir/lamivudine had the lowest healthcare costs of BIC/FTC/TAF, EVG/COBI/FTC/TAF, and DRV/COBI/FTC/TAF, and the lowest pharmacy costs of all regimens, in unadjusted and adjusted analyses and by treatment experience, supporting the economic benefits of DTG/3TC as an initial or switch regimen for HIV-1. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-023-00848-4.

show abstract

Section: Discussionsupporting

confidence: 80%