1 / 11

Background

Determining the opportunity costs of using more expensive first line regimens with regard to treatment access in resource limited settings: A look at tenofovir and stavudine Jennifer Campbell, Erin Koehler, Shaffiq Essajee , Elya Tagar, Megan O’Brien Vienna – July 2010 . Background.

dezso
Download Presentation

Background

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Determining the opportunity costs of using more expensive first line regimens with regard to treatment access in resource limited settings: A look at tenofovir and stavudine Jennifer Campbell, Erin Koehler, Shaffiq Essajee, Elya Tagar, Megan O’Brien Vienna – July 2010

  2. Background Will treatment costs outpace available resources? Flatlining budgets HIV Treatment funding + = Year Cost of 1L treatment with AZT or TDF instead of d4T Total HIV treatment program costs Number of patients requiring treatment

  3. Background: Key questions a. What are the benefits of a more expensive first line regimen with better toxicity and durability profile? b. What is the opportunity cost in terms of patients not treated, given a set budget?

  4. Methodology: Calculator design 10 year forecast of costs, based on 2013 ARV prices MS Excel-based “closed cohort” analysis of 100,000 patients Costs include 1st and 2nd line ARVs and toxicity costs Permits modeling of scenarios where inputs such as estimated improvements in toxicity rates, toxicity treatment costs and migration to 2nd line can be compared with ARV treatment costs Also permits modeling of reduction in loss to follow-up and mortality associated with “better” regimens

  5. Methodology: Input screen shot

  6. Results: Screen shot

  7. Results: opportunity cost for selecting a TDF-based regimen

  8. Results: opportunity cost for selecting a TDF-based regimen Cost for 100K patients for 10 years Patient years treated 182K 25M 104M 79M 569K 569K * Cost includes toxicity, 1L and 2L ARVs

  9. Conclusions • In addition to the break-even analysis, the calculator can estimate the likely net cost of more expensive regimens with the joint savings from reduced toxicity and improved durability. • This additional cost is translated into the patient-years of treatment that could be purchased with a cheaper regimen. • Tools like this one allow us to better understand the impact of more expensive, more effective regimen on access to treatment.

  10. Conclusions • Scenarios like this suggest that a one-size-fits-all change to more expensive regimens may not be advisable. • Countries with constrained budgets and/or low coverage may want to consider starting subsets of patients on more expensive regimens, but leaving others on D4T to maintain scale-up

  11. Thank you Meg O’Brien Jennifer Campbell ElyaTagar Erin Koehler

More Related