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oai:recercat.cat:11351/103412025-10-24T10:33:15Zcom_2072_378070com_2072_378040col_2072_378092

Cabotegravir and Rilpivirine Long-Acting Antiretroviral Therapy Administered Every 2 Months is Cost-Effective for the Treatment of HIV-1 in Spain Moreno, Santiago Rivero Román, Antonio Ventayol, Pere Torralba, Miguel Schroeder, Melanie Falcó, Vicenç Institut Català de la Salut [Moreno S] Hospital Ramón y Cajal CIBERINFEC, Universidad de Alcalá, IRYCIS, Madrid, Spain. [Rivero A] Hospital Reina Sofía, Córdoba, Spain. [Ventayol P] Hospital Son Espases, Palma, Spain. [Falcó V] Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Torralba M] Hospital de Guadalajara, Guadalajara, Spain. [Schroeder M] ViiV Healthcare, Brentford, UK Vall d'Hebron Barcelona Hospital Campus Infeccions per VIH - Tractament Antiretrovirals - Ús terapèutic CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antiviral Agents::Anti-Retroviral Agents Other subheadings::Other subheadings::/therapeutic use DISEASES::Virus Diseases::RNA Virus Infections::Retroviridae Infections::Lentivirus Infections::HIV Infections Other subheadings::Other subheadings::Other subheadings::/drug therapy COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antivíricos::antirretrovirales Otros calificadores::Otros calificadores::/uso terapéutico ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Retroviridae::infecciones por Lentivirus::infecciones por VIH Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia Adherence; Antiretroviral therapy; HIV Adherència; Teràpia antiretroviral; VIH Adherencia; Terapia antirretroviral; VIH Introduction Current antiretroviral therapies (ARTs) have improved outcomes for people living with HIV. However, the requirement to adhere to lifelong daily oral dosing may be challenging for some people living with HIV, leading to suboptimal adherence and therefore reduced treatment effectiveness. Treatment with long-acting (LA) ART may improve adherence and health-related quality of life. The objective of this study was to evaluate the cost-effectiveness of cabotegravir + rilpivirine (CAB+RPV) LA administered every 2 months (Q2M) compared with current ART administered as daily oral single-tablet regimens (STRs) from a Spanish National Healthcare System perspective. Methods A hybrid decision-tree and Markov state-transition model was used with pooled data from three phase III/IIIb trials (FLAIR, ATLAS, and ATLAS-2M) over a lifetime horizon, with health states defined by viral load and CD4+ cell count. Direct costs (in €) were taken from Spanish public sources from 2021 and several deterministic and probabilistic analyses were carried out. An annual 3% discount rate was applied to both costs and utilities. Results Over the lifetime horizon, CAB+RPV LA Q2M was associated with an additional 0.27 quality-adjusted life years (QALYs) and slightly greater lifetime costs (€4003) versus daily oral ART, leading to an incremental cost-effectiveness ratio of €15,003/QALY, below the commonly accepted €30,000/QALY willingness-to-pay threshold in Spain. All scenario analyses showed consistent results, and the probabilistic sensitivity analysis showed cost-effectiveness compared with daily oral STRs in 62.4% of simulations, being dominant in 0.3%. Conclusion From the Spanish National Health System perspective, CAB+RPV LA Q2M is a cost-effective alternative compared with the current options of daily oral STR regimens for HIV treatment. This study, including the journal’s Rapid Service fee, was funded by ViiV Healthcare, Durham, NC, USA. 2023-09-22T10:20:37Z 2023-09-22T10:20:37Z 2023-08 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Moreno S, Rivero A, Ventayol P, Falcó V, Torralba M, Schroeder M, et al. Cabotegravir and Rilpivirine Long-Acting Antiretroviral Therapy Administered Every 2 Months is Cost-Effective for the Treatment of HIV-1 in Spain. Infect Dis Ther. 2023 Aug;12:2039–55. 2193-8229 https://hdl.handle.net/11351/10341 10.1007/s40121-023-00840-y 37452174 001028407900001 http://hdl.handle.net/11351/10341 eng Infectious Diseases and Therapy;12 https://doi.org/10.1007/s40121-023-00840-y Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess application/pdf application/pdf Springer Scientia