Table 4.
Sensitivity Analysis: Cost-effectiveness Ratios for Universal HLA-B*5701 Testing ($/QALY)
| Strategy | Half Primary analysis Test Cost ($34)a | Primary analysis Test Cost ($68) | Twice Primary analysis Test Costa ($136) |
|---|---|---|---|
| Abacavir-based treatment less effective than tenofovir-based treatment | Dominatedb | Dominatedb | Dominatedb |
| Abacavir-based therapy monthly cost advantage versus tenofovir based therapy: | |||
| $4 (primary analysis) | 25,300 | 36,700 | 59,700 |
| $2 | 24,700 | 36,000 | 120,000b |
| $0 | 432,000 b | 840,000b | 1,656,000 b |
| US ART initiation cohort (HLA-B*5701 prevalence ~4.1%) | 29,500 | 45,200 | 77,100 |
| HIV RNA <100,000 copies/ml cohort | 24,300 | 35,400 | 57,700 |
| Universal testing eliminates all unconfirmed HSR diagnoses | 22,700 | 33,500 | 55,300 |
| Universal testing provides no reduction in unconfirmed HSR diagnoses | 26,700 | 38,700 | 62,100 |
QALY: Quality-Adjusted Life Year
Note: Cost-effectiveness ratios are for universal testing compared to no testing unless otherwise indicated.
a
Equivalent to the lowest cost reported by hospital-based laboratories.
b
Compared to tenofovir-based first-line therapy; “Dominated” indicates that universal HLA-B*5701 testing has lower quality–adjusted life expectancy and a higher cost compared to tenofovir-based first-line therapy.