PIN61 Cost-Effectiveness Study of the Use of Dolutegravir Compared with Efavirenz in Combination with Tenofovir and Emtricitabine, As the First LINE for the Care of Patients NEWLY Diagnosed with HIV or WHO Have NOT Started ART in Colombia.

Abstract

Determine the cost effectiveness of using the dolutegravir compared to efavirenz in combination with tenofovir and emtricitabine, as the first line for the attention of newly diagnosed patients or not have started ART in Colombia. Cost-effectiveness analysis from the perspective of the third payer based on a hypothetical cohort Markov analytical model (n = 100) evaluate achievement of viral suppression, discontinuity, years of life saved in ten years how time horizon. The target population was adult frontline patients for the care of patients newly diagnosed with HIV or who did not start ART. The response parameters used were obtained from the literature and the cost contributions were obtained from the official dates (SISMED, CAC, ISS manual). Univariate sensitivity analysis and Monte Carlo type sensitivity analysis with 1000 iterations were performed. A 5% annual discount rate was applied for costs and results. Total costs of treatment were $2,708,810 USD for dolutegravir, $3,324,685 USD for efavirenz; savings from $-615,875 USD. Incremental effectiveness was years of life saved (-0,24), viral suppression (0,11) discontinuity (1.26). The cost effectiveness ratio for years of life saved was $2,589,679 USD and for discontinuity it was $490,658 USD. For viral suppression the cost effectiveness ratio dolutegravir was dominant over efavirenz. dolutegravir compared to efavirenz was shown to be a cost-effective strategy for managing PLHIV that they start antiretroviral therapy for the first time since perspective of the Colombian health system in base case conditions being dominant for the decrease in viral suppression.