Background Truvada, a fixed-dose combination of antiretroviral drugs (emtricitabine and tenofovir fumarate) indicated for HIV-1, was the 12th most expensive drug prescribed in Piedmont during 2009–2010, with a growth of 12%.
Since July 2011 the School of Hospital Pharmacy in Turin has developed a two-year pharmacoeconomic project regarding high-cost drugs.
Purpose To provide to the decision-makers with a management tool to evaluate the treatment costs of HIV patients.
Materials and Methods The legislation and articles in epidemiology and pharmacoeconomic journals were reviewed. Drummond’s Weighted Checklist method was used to evaluate the pharmacoeconomic articles. A Budget Impact model, based only on the drug costs, was built. The treatment-naive population (290) was extrapolated from the incidence data in Piedmont in 2010. The treatment options relied on the US Department of Health and Human Services guidelines and on the pharmacoeconomic studies. The model suggested a combination of Truvada with: i) efavirenz (NNRTI, Sustiva), ii) atazanavir (PI, Reyataz)+ritonavir (PI booster, Norvir); iii) darunavir (PI, Prezista)+ritonavir (PI booster, Norvir).
Results The daily treatment cost for a treatment-naive patient varies from €21.78 to €30.64, while the annual expenditure varies from €7,949.17 to €11,184.45. The Budget Impact was calculated assuming that the 290 new HIV cases had been treated for one year with one of the therapeutic strategies provided. The variation in comparison with association i) were respectively +24.64% for combination ii) and +40.70% for combination iii). Treatment iii) was the most expensive (€324,3491.37) and increased the annual expenditure by 40.70% (€938,233.23) as compared with treatment i) (€2305,258.14).
Conclusions The Budget Impact analysis will be used to perform pre-assessments of expenditure in order to set up health care programmes for the allocation of the economic resources. A pharmacoeconomic analysis of cost-effectiveness will be performed between the associations Truvada + Reyataz and Truvada + Sustiva.
No conflict of interest.
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