The cost-effectiveness analysis of initiating HIV/AIDS treatment with efavirenz-based regimens compared with nevirapine-based regimens in Thailand.

ABSTRACT

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.