Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Economic modeling of the combined effects of HIV-disease, cholesterol and lipoatrophy based on ACTG 5142 trial data. | Simpson et al. Cost Effectiveness and Resource Allocation 2011 9 5 http content 9 1 5 COST EFFECTIVENESS AND RESOURCE ALLOCATION RESEARCH Open Access Economic modeling of the combined effects of HIV-disease cholesterol and lipoatrophy based on ACTG 5142 trial data 1 3 2 2 4 2 Kit N Simpson Birgitta Dietz Robert W Baran Kevin W Garren Sharon A Riddler Menaka Bhor and Richard H Haubrich5 Abstract Background This study examines the cost and consequences of initiating an ARV regimen including Lopinavir ritonavir LPV r or Efavirenz EFV using data from a recent clinical trial in a previously published model of HIV-disease. Methods We populated the Markov model of HIV-disease with data from ACTG 5142 study to estimate the economic outcomes of starting ARV therapy with a PI-containing regimen as compared to an NNRTI-containing regimen given their virologic and immunologic efficacy and effects on cholesterol and lipoatrophy. CNS toxicities and GI tolerability were not included in the model because of their transient nature or low cost remedies and therefore lack of economic impact. CD4 T-cell counts and the HIV-1 RNA viral load values from the study were used to assign a specific health state HS to each patient for each quarter year. The resulting frequencies used as raw data directly into the model obviate the reliance on statistical tests and allow the model to reflect actual patient behavior in the clinical trial. An HS just below the last observed HS was used to replace a missing value. Results The modeled estimates undiscounted for the LPV r-based regimen resulted in quality-adjusted life months QALMs gained over a lifetime compared to the EFV-based regimen. The LPV r-based regimen incurred 7 458 greater cost over a lifetime due to differences in drug costs and survival. The incremental cost effectiveness ratio using the discounted cost and QALYs was 88 829 QALY. Most of the higher costs accrue before the 7th year of treatment and .
