Emtricitabine and tenofovir DF a worthy pair in the US, UK
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Table 2. Predicted economic and health outcomes for the UK Duration of first line therapy (years) Total lifetime costs (£) QALYs gained
3TC/ABC
3TC/ZDV
FTC/TDF
4.9
4.8
5.9
269 487
266 785
267 603
14.38
14.20
14.50
However, for FTC/TDF, compared with 3TC/ZDV and 3TC/ABC, the cost-utility ratios were £2727/QALY gained and –£15 525/QALY gained, respectively. The researchers for this analysis indicated that their findings "were driven by better efficacy and tolerability" of FTC/ TDF relative to 3TC/ABC and 3TC/ZDV. 1. Brogan AJ, et al. Cost-effectiveness of tenofovir/emtricitabine compared with other NRTI pairs in treatment-naive adults with HIV infection in the USA. 9th International Congress on Drug Therapy in HIV Infection : abstr. P309, 9 Nov 2008. 2. Brogan AJ, et al. NRTI backbone pairs for treatment-naive adults with HIV infection: a UK economic evaluation. 9th International Congress on Drug Therapy in HIV Infection : abstr. P306, 9 Nov 2008. 801099989
FTC/TDF a strong pair in the US . . . The model predicted that the FTC/TDF recipients in the US would remain on the first-line therapy for longer, accrue a lower total cost and achieve a greater gain in QALYs than the 3TC/ZDV and 3TC/ABC recipients [see table 1].1 Table 1. Predicted economic and health outcomes for the US Duration of first line therapy (years) Total lifetime costs ($US) QALYs gained
3TC/ABC
3TC/ZDV
FTC/TDF
5.0
4.9
6.0
629 143
631 436
620 673
14.10
13.89
14.22
The researchers noted that "the results were robust to parameter uncertainty and modelling assumptions". They also revealed that "cost savings were largely due to avoidance of more expensive subsequent lines of therapy and lower costs associated with adverse events and disease-related resource use".
. . . and in the UK For the UK patients, the model predicted that FTC/ TDF would be used for longer than the comparator NRTI pairs, and recipients would achieve greater gains in QALY, although FTC/TDF would only be less expensive than 3TC/ZDV [see table 2].2
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PharmacoEconomics & Outcomes News 10 Jan 2009 No. 569
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