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A cost-effectiveness analysis of Maraviroc in treatment-experienced HIV patients in Scotland

Purpose of the study

The objective of this study was to perform a cost-effectiveness analysis of maraviroc therapy in patients with triple-class drug experience and/or triple-class drug resistance in Scotland, based on data from the MOTIVATE trials.

Methods

A Markov cohort model was developed in Excel based on the previously published ARAMIS model [1]. Lifetime Maraviroc (MVC) treatment plus Optimized Background Therapy (OBT) was compared to standard OBT treatment in patients infected with CCR5-monotropic HIV-1. Disease states were defined according to CD4 cell counts and transition probabilities and drop-out rates were based on the MOTIVATE trials, complemented with data from the published literature. The model was populated with UK-specific costs (scaled to 2007 levels) and mortality rates for the Scottish general population. Efficacy was measured in quality-adjusted life-years (QALYs) and the analysis was performed from the perspective of the NHS. The base case input values and assumptions reflect a recent reimbursement submission.

Summary of results

MVC was associated with an incremental gain of 1.9 QALYs and incremental costs of £29,503 compared to standard OBT treatment, resulting in an incremental cost-effectiveness ratio (ICER) of £15,401 per QALY. Sensitivity analyses of input parameters and model assumptions produced ICERs in the range of £10,000–30,000.

Conclusion

The results indicated that it is potentially cost-effective to treat patients with MVC compared to standard OBT treatment in highly treatment-experienced HIV patients in Scotland.

References

  1. Chancellor J, et al: A microsimulation of the cost-effectiveness of maraviroc for antiretroviral treatment-experienced HIV-infected individuals. ISPOR 13th Annual International Meeting. Toronto, Canada, 3–7. 2008, May : Presentation IN3

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Lekander, I., Berg, J., Christie, A. et al. A cost-effectiveness analysis of Maraviroc in treatment-experienced HIV patients in Scotland. JIAS 11, P315 (2008). https://doi.org/10.1186/1758-2652-11-S1-P315

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  • DOI: https://doi.org/10.1186/1758-2652-11-S1-P315

Keywords

  • Incremental Cost
  • Drug Experience
  • Maraviroc
  • Cohort Model
  • Incremental Gain