PIN7 ECONOMIC EVALUATION OF ELVITEGRAVIR/COBICISTAT/EMTRICITABINE/TENOFOVIR ALAFENAMIDE (GENVOYA®) AS A COMPLETE TREATMENT REGIMEN FOR HIV-1 INFECTION IN ADULTS WHO ARE ANTIRETROVIRAL THERAPY-NAÏVE IN MEXICO

Abstract

EVG/COBI/FTC/TAF (GENVOYA®) is a single-tablet regimen for the treatment-naive and virologically suppressed HIV-1 infected adult and pediatric patients 12 years of age and older with no known mutations associated with resistance to the individual components of EVG/COBI/FTC/TAF. It contains three different types of HIV drugs: two nucleotide/nucleoside reverse transcriptase inhibitors and one integrase inhibitor. It also contains a pharmacokinetic enhancer, a drug that has no activity against HIV, but boosts the blood levels and effectiveness of other drugs. The objective of this study is to assess the Economic Efficiency of EVG/COBI/FTC/TAF vs the current antiretroviral-naive (RAL+FTC/TDF y EFV and FTC/TDF) regimen in Mexico. Similar efficacy and safety of EVG/COBI/FTC/TAF regarding the current ARV regimens used in Mexico was based on clinical evidence from 3 phase 3 clinical trials. Hence a cost minimization analysis was conducted to assess the expected treatment costs for HIV-1 infection in adults who are antiretroviral therapy-naïve. The costs evaluated included the costs of HIV-1 treatment regimen currently used in Mexico (RAL+FTC/TDF and EFV+FTC/TDF) compared to EVG/COBI/FTC/TAF. The time horizon measured was one year, so no discount rate was considered. The costs are presented in USD. This study was conducted from the institutional perspective. The evidence and the results form the cost-minimization analysis confirms that EVG/COBI/FTC/TAF the less costly alternative when compared to the current HIV-1 regimen average cost, $4,427.08 ($3,284.37-$4,569.79) vs $6,239.58 ($5,015.62-$6,463.54), respectively. So EVG/COBI/FTC/TAF generates $1,812.50 ($1,731.25-$2,893.75) savings per patient. The base case analysis indicates that adding EVG/COBI/FTC/TAF is a cost-saving alternative. For a cohort of 1,000 patients the potential savings are $1,812,500.00 for the public institutions in Mexico. Adding EVG/COBI/FTC/TAF to the Mexican formularies generates important savings for the Mexican healthcare system (since EVG/COBI/FTC/TAF lead to a reduction of direct medical) and provides similar patient outcomes compared to (RAL+FTC/TDF y EFV and FTC/TDF.