We evaluated the costs and effectiveness of starting highly active antiretroviral therapy (HAART) at different points during the course of HIV infection, defined on the basis of CD4 T-lymphocytes counts. The study considered 3,250 HAART-naive patients of the Italian Cohort Naive Antiretrovirals (ICONA), enrolled and followed between 1997 and 2002. In correspondence to the thresholds of 500,350, and 200 CD4 cells/mm3, we selected immediate and deferred groups accounting for lead-time bias. The effects of immediate vs. deferred treatment on AIDS-free survival and direct health costs were estimated stratifying on the propensity score of immediate HAART initiation. The incremental cost-effectiveness ratio (ICER) and the cost-effectiveness acceptability curve were also obtained. Although immediate HAART initiation did not affect incidence AIDS and death at high CD4 levels, starting HAART with 200-349 CD4 cells/mm3 rather than deferring it below 200 CD4 cells/mm3, proved to be cost-effective. © Springer Medizin Verlag 2006.
CITATION STYLE
Merito, M., & Pezzotti, P. (2006). Comparing costs and effectiveness of different starting points for highly active antiretroviral therapy in HIV-positive patients: Evidence from the ICONA cohort. European Journal of Health Economics, 7(1), 30–36. https://doi.org/10.1007/s10198-005-0327-9
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