cost-effectiveness of the third-agent class in treatment-naive human immunodeficiency virus-infected patients in portugal成本效益third-agent类的首次治疗人类免疫缺陷病毒感染患者在葡萄牙.pdfVIP

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cost-effectiveness of the third-agent class in treatment-naive human immunodeficiency virus-infected patients in portugal成本效益third-agent类的首次治疗人类免疫缺陷病毒感染患者在葡萄牙.pdf

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cost-effectiveness of the third-agent class in treatment-naive human immunodeficiency virus-infected patients in portugal成本效益third-agent类的首次治疗人类免疫缺陷病毒感染患者在葡萄牙

Cost-Effectiveness of the Third-Agent Class in Treatment- Naive Human Immunodeficiency Virus-Infected Patients in Portugal ˜ 1,2 ´ 3 ˆ 3 Filipa Aragao *, Jose Vera , Ines Vaz Pinto ´ ´ ˜ ´ 1 Escola Nacional de Saude Publica, Universidade Nova de Lisboa, Lisboa, Lisboa, Portugal, 2 Associac¸ao SER+, Rua Andre Homem, Cascais, Cascais, Portugal, 3 HPP - Hospital de Cascais, Alcabideche, Cascais, Portugal Abstract Introduction: Current Portuguese HIV treatment guidelines recommend initiating antiretroviral therapy with a regimen composed of two Nucleoside Reverse Transcriptase Inhibitors plus one Non-nucleoside Reverse Transcriptase Inhibitor (2NRTI+NNRTI) or two Nucleoside Reverse Transcriptase Inhibitors plus one boosted protease inhibitor (2NRTI+PI/r). Given the lower daily cost of NNRTI as the third agent when compared to the average daily costs of PI/r, it is relevant to estimate the long term impact of each treatment option in the Portuguese context. Methods: We developed a microsimulation discrete events model for cost-effectiveness analysis of HIV treatment, simulating individual paths from ART initiation to death. Four driving forces determine the course of events: CD4+ cell count, viral load, resistance and adherence. Distributions of time to event are conditional to individuals’ characteristics and past history. Time to event was modeled using parametric survival analysis using Stata 11H. Disease progression