Table 4.

Model costs by treatment, patient monitoring characteristic, and adverse event

Parameter	Costa	Distributionb	Reference
Product acquisition costs
First-line
Atripla®	4,918	Gamma	1, 13
Stribild™	6,559
Second-linec	6,977
Third-lined	9,092
Patient monitoring costse
No virologic failuref	914	Gamma	32
Virologic failure
CD4 ≥50 cells/mm3,g	1,561
CD4 <50 cells/mm3,h	1,620
Patient receiving new line of therapyi	113
Cost of treating adverse events
Rash	226	Gamma	32
Elevated lipids	186		13, 32
CNS symptoms	226		32
Renal abnormalities
No acute kidney injury	914		32
Acute kidney injury	33,594		14, 32
Chronic kidney disease with dialysis	48,665		15
Other adverse events causing discontinuation	226		32

Notes:

^aAll costs are per 12-week cycle and are reported in 2012 US dollars;

^bdistributions used in probabilistic sensitivity analysis;

^csecond-line treatment defined as 50% receiving atazanavir with boosted ritonavir (atazanavir/r) and two NRTIs, 50% receiving darunavir with boosted ritonavir (darunavir/r) and two NRTIs;

^dthird-line treatment defined as 50% receiving darunavir/r + etravirine, 50% receiving maraviroc + raltegravir + optimized background therapy;

^eall cost estimates were averages of high and low managed care rates;²⁵

^fcost included baseline monitoring components, consisting of a 10-minute physician office visit, one blood draw, one chemistry panel, one complete blood count, one CD4 count, and one viral load assessment (ultrasensitive quantification);

^gcost included baseline patient monitoring plus a 15-minute physician office visit, one blood draw, and one viral load assessment;

^hcost included baseline patient monitoring plus a 25-minute physician office visit, one blood draw, and one viral load assessment;

ⁱcost included a 15-minute physician office visit.

Abbreviations: CNS, central nervous system; NRTIs, nucleoside reverse transcriptase inhibitors.