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Article Abstract
Objective: The ANRS 170 QUATUOR study demonstrated the noninferiority of a triple antiretroviral therapy (ART) taken four consecutive days on and 3 days off (hereafter referred to as a 4/7-days strategy) compared to a triple therapy taken 7 days a week (7/7-days strategy) for persons with HIV (PWH) and with suppressed viremia. We investigated corresponding cost-effectiveness issues.
Design: Cost-effectiveness study.
Setting: France.
Participants: All 636 persons involved in the primary analysis of the QUATUOR trial (318 per arm). Analyses were based on 10 000 simulations replicating the trial. Additional analyses included estimating the national impact of spreading the 4/7-days strategy all over France.
Intervention: A 4/7-days strategy, compared to a 7/7-days strategy.
Main Outcome Measures: Effectiveness was considered as the noninferiority of the 4/7-days strategy, main criterion of the trial primary analysis. Direct health resource costs ( year2022 €) were considered and included costs for ART, laboratory tests, co-medications, hospitalizations, and medical consultations.
Results: The mean individual costs for ART were €3678 [95% confidence interval (CI) 3593-3763] and €6450 (6301-6596) in the 4/7-days and 7/7-days arm, respectively ( P < 0.0001), and constituted the single element with a statistical difference between the two strategies. Adopting a 4/7-days regimen in 20% of the potential recipients in France was estimated to provide annual savings of €61 752 467 (61 569 005-61 925 136).
Conclusion: The 4/7-day strategy dominates the 7/7-day strategy, providing substantial ART-related cost savings while maintaining treatment effectiveness. Study results support generalizing the proposal of 4/7-days regimens in France, in persons eligible for this strategy.
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| http://dx.doi.org/10.1097/QAD.0000000000004215 | DOI Listing |
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