Table 3.
Cost-Effectiveness Results for HLA-B*5701 Strategies to Guide Selection of First-Line Antiretroviral Regimens.
| Strategy | Confirmed HSR (%) | Total HSR (%) | Lifetime Cost per Person ($) | Quality-Adjusted Life-Months per Person | Cost-Effectiveness Ratio ($/QALY) |
|---|---|---|---|---|---|
| No testing, initiate with abacavir-based therapy | 2.73 | 7.83 | 472,210 | 194.75 | --- |
| No testing, initiate with tenofovir-based therapy, substitute zidovudine and lamivudine a | 0 | 0 | 472,290 | 194.71 | Dominated b |
| Universal HLA-B*5701 testing | 0 | 3.36 | 472,320 | 194.79 | 36,700 |
| Initiate with tenofovir based therapy, substitution HLA-B*5701 testing a | 0 | 0.07 | 472,550 | 194.79 | Dominated b |
| No testing, initiate with tenofovir-base therapy, substitute abacavir and lamivudine a | 0.06 | 0.16 | 472,550 | 194.79 | Dominated b |
QALY: Quality-Adjusted Life Year; all costs and quality-adjusted life months or years discounted at 3% p.a.
HSR: systemic hypersensitivity reaction
a
if nephrotoxicity requiring tenofovir discontinuation occurs
b
A dominated strategy has a higher cost and an equal or lower quality-adjusted life expectancy compared to the previous strategy.