INTRODUCTION: The GESIDA guidelines propose preferential guidelines for initiating antiretroviral treatment in HIV-infected patients. The objective of this analysis is to compare the costs and efficacy of darunavir / r QD against other potent protease inhibitors (PI) recommended by GESIDA in naïve patients.
METHODS: Using a cost-effectiveness model, the recommended IP / r were compared as preferred or alternative guidelines in naïve patients, together with a baseline treatment with 2 ITIAN. Efficacy was measured by virological response (viral load < 50 copies / ml) at 48 weeks adjusted for baseline viral load levels and CD4 counts. To generate the "efficiency frontier" and cost-effectiveness ratios, Spanish costs and 48-week efficiency rates were used.
RESULTS: The model estimated that the start of treatment in naïve with darunavir / r QD was shown as the preferred option based on a more cost-effective IP / r. The average cost of HAART per responding patient was lower to darunavir / r (13,420 €) than for atazanavir / r (14,000 €) or lopinavir / r (13,815 €). It was estimated that darunavir / r would be the most efficient preferred IP, while atazanavir / r QD and lopinavir / r IDB would be "dominated" options, standing outside the efficiency frontier. Starting from a fixed budget of € 10 million, it was estimated that the starting pattern with darunavir / r QD would achieve a greater number of responding patients (745) than with atazanavir / r QD (714) or lopinavir / r IDB (724) . At the same time, darunavir / r QD would reduce the number of patients who would fail treatment (150) compared to atazanavir / r QD (172) or lopinavir / r (286).
CONCLUSIONS: According to this model, darunavir / r QD is the most cost-effective preferred IP / r for the treatment of HIV-1 infection based on IP / r in naïve patients in Spain.
