HTA and HIV: The Case of Dual NRTI Backbones in the Italian Setting

Elisabetta Garagiola, Emanuela Foglia, Lucrezia Ferrario, Giovanni Cenderello, Antonio Di Biagio, Barbara Menzaghi, Giuliano Rizzardini and Davide Croce
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Elisabetta Garagiola: Centre on Health Economics, Social and Health Care Management, LIUC Business School, LIUC-Università Cattaneo, 21053 Castellanza, Italy
Emanuela Foglia: Centre on Health Economics, Social and Health Care Management, LIUC Business School, LIUC-Università Cattaneo, 21053 Castellanza, Italy
Lucrezia Ferrario: Centre on Health Economics, Social and Health Care Management, LIUC Business School, LIUC-Università Cattaneo, 21053 Castellanza, Italy
Giovanni Cenderello: Department of Infectious Diseases, Galliera Hospital, 16128 Genova, Italy
Antonio Di Biagio: Unit of Infectious Diseases, IRCCS San Martino IST Hospital, 16132 Genova, Italy
Barbara Menzaghi: Department of Infectious Diseases, Valle Olona Hospital, 21052 Busto Arsizio, Italy
Giuliano Rizzardini: Department of Infectious Diseases, Fatebenefratelli Sacco Hospital, 20157 Milan, Italy
Davide Croce: Centre on Health Economics, Social and Health Care Management, LIUC Business School, LIUC-Università Cattaneo, 21053 Castellanza, Italy

IJERPH, 2020, vol. 17, issue 23, 1-17

Abstract: The aim of this study is to analyze the potential advantages of emtricitabine/tenofovir alafenamide (FTC/TAF) introduction, creating evidence-based information to orient strategies to reduce costs, thus preserving effectiveness and appropriateness. An Health Technology Assessment (HTA) was implemented in the years 2017–2018 comparing the dual backbones available in the Italian market: FTC/TAF, FTC/TDF (tenofovir disoproxil fumarate/emtricitabine) and ABC/3TC (abacavir/lamivudine). From an efficacy point of view, FTC/TAF ensured a higher percentage of virologic control and a better safety impact than FTC/TDF (improving the renal and bone safety profile, as well as the lipid picture). From an economic point of view, the results revealed a 4% cost saving for the Italian National Healthcare Service NHS with FTC/TAF introduction compared with the baseline scenario. Qualitative perceptions’ results showed that FTC/TAF would decrease the burden of adverse events management, increasing the accessibility of patients to healthcare providers (FTC/TAF: 0.95, FTC/TDF: 0.10, ABC/3TC: 0.28; p -value: 0.016) and social costs (FTC/TDF: −0.23, FTC/TAF: 1.04, ABC/3TC: 0.23; p -value < 0.001), improving patient quality of life (FTC/TDF: 0.31, FTC/TAF: 1.85, ABC/3TC: 0.38; p -value < 0.001). Healthcare services may consider the evidence provided by the present study as an opportunity to include HIV patients in a more adequate antiretroviral treatment arm, guaranteeing a personalized clinical pathway, thus becoming more efficient and effective over time.

Keywords: HIV; dual NRTI backbones; HTA; Italy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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