CostEffectiveness Analysis of Raltegravir in Treatment Experienced HIV Patients in Switzerland

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Cost-Effectiveness Analysis of Raltegravir in
Treatment -Experienced HIV Patients in Switzerland
Elamin H. Elbasha1, Thomas D. Szucs2, Mohammad A.
Chaudhary1, Ritesh N. Kumar1, Alexander
Roediger3, John R. Cook1 Milos Opravil4 1
Merck and Co. Inc, USA 2University of Zurich,
Zurich, Switzerland, 3Merck Sharpe and Dohme,
Zurich, Switzerland, 4University Hospital Zurich,
Zurich, Switzerland.
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Model Overview

• State-transition cohort model was developed using
  Mathematica Version 6
• Continuous-time Markov process with limited
  history
• Two treatment strategies evaluated
• A. Placebo OBT
• B. Raltegravir OBT
• Three sets of differential equations estimated
  within the model corresponding to 3 broad health
  states
• Patients with No Opportunistic infections (OI)
• Patients with History of OI
• Patients with Current OI

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HIV Diseases Progression Model
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Cost-Effectiveness of Raltegravir OBT versus OBT
Assumes raltegravir daily cost of CHF 46.44 QALY
quality-adjusted life yearICER incremental
cost-effectiveness ratio
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Summary

• Long-term outcomes of raltegravir therapy were
  evaluated using a cohort state-transition model.
• The Model suggests raltegravir provides
  substantial clinical benefits in terms of longer
  life expectancy and better quality of life
• Raltegravir is cost-effective when added to OBT
  versus OBT alone
• Cost-effectiveness results are sensitive to cost
  of raltegravir and treatment duration with
  raltegravir