Volume 13 Supplement 4

Abstracts of the Tenth International Congress on Drug Therapy in HIV Infection

Open Access

Cost-efficacy analysis of the MONET trial using Spanish antiretroviral drug prices

  • JR Arribas1,
  • A Hill2,
  • I Garcia3 and
  • A Anceau4
Journal of the International AIDS Society201013(Suppl 4):P235

https://doi.org/10.1186/1758-2652-13-S4-P235

Published: 8 November 2010

Background

In virologically suppressed patients, switching to DRV/r monotherapy maintains HIV RNA suppression, and could also lower treatment costs.

Methods

In the MONET trial 256 patients with HIV RNA <50 copies/mL on current HAART for over 24 weeks (NNRTI based (43%), or PI based (57%)), switched to DRV/r 800/100 mg once daily, either as monotherapy (n=127) or with 2NRTI (n=129). The Spanish costs per patient with HIV RNA below 50 copies/mL were calculated, using a "switch included" analysis at Week 96, to account for additional antiretrovirals taken after initial treatment failure. Published prices were used.

Results

In the ITT switch included analysis, HIV RNA <50 copies/mL by Week 96 was 92.1% versus 90.7% in the DRV/r monotherapy and control arms. No patients in either arm developed phenotypic resistance to DRV. Before the trial, the mean annual cost of antiretrovirals was €4612 for patients on NNRTI based HAART, and €9217 for patients on PI based HAART. During the MONET trial, the mean annual per-patient cost of antiretrovirals was €9915 in the triple therapy arm, of which 45% was from NRTIs and 55% from PIs. The mean per-patient cost in the monotherapy arm was €5915, a saving of 40%. We estimated 65,000 people treated with antiretrovirals in Spain (50% NNRTI based, 50% PI based) and 15% of patients (9,750) eligible for PI monotherapy. A switch to DRV/r monotherapy could cut the two-year cost of antiretroviral treatment for these patients, from €137 million to €115 million, a saving of €22 million over two years.

Conclusions

Based on the MONET results, the lower cost of DRV/r monotherapy versus triple therapy in Spain would allow more patients to be treated for a fixed budget, or a saving of up to €22 million over two years, if all eligible patients were switched, while maintaining HIV RNA suppression below 50 copies/mL.

Authors’ Affiliations

(1)
Hospital La Paz
(2)
Liverpool University
(3)
Janssen-Cilag
(4)
Janssen France

Copyright

© Arribas et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://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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