The Cost-Effectiveness Analysis of Initiating HIV/AIDS Treatment with Efavirenz-Based Regimens Compared with Nevirapine-Based Regimens in Thailand
Usawadee Maleewong*,**, Vithaya Kulsomboon PhD**, Yot Teerawattananon MD, PhD***
Affiliation : * The Faculty of Pharmacy, Mahasarakham University, Thailand ** Department of Social and administrative Pharmacy, The Faculty of Pharmaceutical Sciences, Chulalongkorn University, Thailand *** Health Intervention and Technology Assessment Program (HITAP), Nonthaburi, Thailand
Objectives: The aim of this study is to evaluate the cost-utility of the treatment, starting with EFZ-based
therapy, compared with NVP-based therapy in Thai HIV/AIDS patients.
Material and Method: The study adopted a health care provider perspective. A probabilistic Markov model
was applied to Thai HIV/AIDS patients aged 15 to 65 years. Input parameters were extracted from a cohort
study of four regional hospitals. The study explored the effects of uncertainty around input parameters.
Results : For those patients with a different baseline CD4, initial therapy using EFZ-based regimens was the
preferable choice for all subgroups. Given a maximum acceptable willingness to pay (WTP) threshold of
300,000 Baht/DALY averted starting with EFZ-based regimens was cost-effective for patients with a baseline
CD4 count less than 250 cells/mm3 and in all patient age groups, except those who were 20 years old.
Conclusions: The results suggest that starting with EFZ-based regimens was the preferable choice and it
should be used as the first line regimen for Thai HIV/AIDS patients.
Keywords : Cost-effectiveness, HIV/AIDS treatment, Efavirenz-based regimens, Nevirapine-based regimens, Thailand
