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Economic evaluation of ART in resource-limited countries.

Publication ,  Journal Article
Loubiere, S; Meiners, C; Sloan, C; Freedberg, KA; Yazdanpanah, Y
Published in: Curr Opin HIV AIDS
May 2010

PURPOSE OF REVIEW: In the face of increasing economic constraints, it is critically important to evaluate how best to utilize available resources. In this article, we review the growing number of cost-effectiveness analyses of HIV treatment with antiretroviral therapy (ART) in resource-limited settings. We focus on studies that evaluate when to start therapy, what therapy to start with and what to switch to based on what criteria. RECENT FINDINGS: Recent findings show that earlier ART initiation based on CD4 cell count criteria (CD4 cell counts <350 cells/microl) can be cost effective in most resource-limited settings. They also suggest that initiating ART with tenofovir as a component of the first-line regimen is an efficient use of resources compared with initiating ART with stavudine. Finally, they show that HIV RNA monitoring combined with CD4 monitoring is more effective than CD4 monitoring alone, although this strategy was not yet found to be cost effective in all studies. Nearly all studies demonstrate, however, that the cost-effectiveness ratio of HIV RNA monitoring will become more attractive as the cost of HIV RNA tests and second-line ART regimens decrease. SUMMARY: Substantial research shows that ART for HIV disease in resource-limited settings is cost effective. Improved initial regimens and increased laboratory monitoring may provide both clinical benefit and good value for money. Further price reductions of laboratory tests and recent antiretroviral drugs are needed to guarantee the cost-effectiveness of these required improvements.

Duke Scholars

Published In

Curr Opin HIV AIDS

DOI

EISSN

1746-6318

Publication Date

May 2010

Volume

5

Issue

3

Start / End Page

225 / 231

Location

United States

Related Subject Headings

  • Virology
  • Viral Load
  • Tenofovir
  • Stavudine
  • RNA, Viral
  • Organophosphonates
  • Humans
  • Health Care Costs
  • HIV Infections
  • Drug Monitoring
 

Citation

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Chicago
ICMJE
MLA
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Loubiere, S., Meiners, C., Sloan, C., Freedberg, K. A., & Yazdanpanah, Y. (2010). Economic evaluation of ART in resource-limited countries. Curr Opin HIV AIDS, 5(3), 225–231. https://doi.org/10.1097/COH.0b013e3283384a9d
Loubiere, Sandrine, Constance Meiners, Caroline Sloan, Kenneth A. Freedberg, and Yazdan Yazdanpanah. “Economic evaluation of ART in resource-limited countries.Curr Opin HIV AIDS 5, no. 3 (May 2010): 225–31. https://doi.org/10.1097/COH.0b013e3283384a9d.
Loubiere S, Meiners C, Sloan C, Freedberg KA, Yazdanpanah Y. Economic evaluation of ART in resource-limited countries. Curr Opin HIV AIDS. 2010 May;5(3):225–31.
Loubiere, Sandrine, et al. “Economic evaluation of ART in resource-limited countries.Curr Opin HIV AIDS, vol. 5, no. 3, May 2010, pp. 225–31. Pubmed, doi:10.1097/COH.0b013e3283384a9d.
Loubiere S, Meiners C, Sloan C, Freedberg KA, Yazdanpanah Y. Economic evaluation of ART in resource-limited countries. Curr Opin HIV AIDS. 2010 May;5(3):225–231.

Published In

Curr Opin HIV AIDS

DOI

EISSN

1746-6318

Publication Date

May 2010

Volume

5

Issue

3

Start / End Page

225 / 231

Location

United States

Related Subject Headings

  • Virology
  • Viral Load
  • Tenofovir
  • Stavudine
  • RNA, Viral
  • Organophosphonates
  • Humans
  • Health Care Costs
  • HIV Infections
  • Drug Monitoring