Effectiveness and cost effectiveness of early and late prevention of HIV/AIDS progression with antiretroviral or antibiotics in Southern African adults [corrected] [published erratum appears in AIDS CARE 2006 May;18(4):415-6].
As HIV/AIDS drugs are becoming more widely available in Southern Africa, we compared the effectiveness and cost effectiveness of different treatment options, using a Markov Monte Carlo simulation model based on published estimates of disease progression, treatment effectiveness and health care costs...
| Publicado en: | AIDS Care Vol. 18; no. 2; pp. 109 - 121 |
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| Autor principal: | |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Feb2006
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106468707&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106468707 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09540121 AAE jtl: AIDS Care issn: 09540121 maglogo: N pubinfo: dt: Feb2006 vid: 18 iid: 2 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 106468707 106468707 2009206290 10.1080/09540120500159334 NLM16338768 106468707 ppf: 109 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Effectiveness and cost effectiveness of early and late prevention of HIV/AIDS progression with antiretroviral or antibiotics in Southern African adults [corrected] [published erratum appears in AIDS CARE 2006 May;18(4):415-6]. aug: au: Bachmann MO affil: Professor of Health Care Interfaces, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK; m.bachmann@uea.ac.uk sug: subj: Antibiotics Therapeutic Use Antiviral Agents Therapeutic Use Cost Benefit Analysis Disease Progression Prevention and Control Anti-HIV Agents Adult CD4 Lymphocyte Count Confidence Intervals Descriptive Statistics Early Intervention Health Services Accessibility Models, Statistical Odds Ratio Quality of Life Sensitivity and Specificity South Africa Treatment Outcomes Human Adult: 19-44 years ab: As HIV/AIDS drugs are becoming more widely available in Southern Africa, we compared the effectiveness and cost effectiveness of different treatment options, using a Markov Monte Carlo simulation model based on published estimates of disease progression, treatment effectiveness and health care costs. Cost and outcome values were discounted. Quality of life was considered. Acceptability curves summarized uncertainties. Sensitivity analyses tested assumptions. Results showed that triple antiretroviral therapy (ARV) plus antibiotics would prolong life by 6.7 undiscounted years if provided 'late' (CD4 = 200 cells/microl) and by 9.8 years if provided 'early' (CD4 = 350 cells/microl). The incremental undiscounted costs per year of life gained, compared to no preventive therapy, were $17 for isoniazid plus cotrimoxazole started late, $244 for both antibiotics started early, $2454 for ARV plus antibiotics started late and $2784 for ARV plus both antibiotics started early. The discounted incremental costs per quality adjusted life year (QALY) gained were, respectively, $29 saving, $254, $4937 and $3057. Late ARV plus both antibiotics was the strategy most likely to be cost effective if society was willing to pay more than $2000 per life year gained. Cost-effectiveness estimates were sensitive to discounting and assumed treatment costs but were less sensitive to assumed treatment effectiveness. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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