Evidence map›Paper›PMID 21182345›Full record

Trial reportPharmacoEconomics2010

Costs to achieve undetectable HIV RNA with darunavir-containing highly active antiretroviral therapy in highly pretreated patients: the POWER experience.

Andrew M Hill, Bonaventura Clotet, Margaret Johnson, Matthias Stoll, Nicholas Bellos, Erik Smets

Abstract readClinical Trial, Phase IIMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in PharmacoEconomics, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Andrew M HillDepartment of Pharmacology University of Liverpool, Liverpool, UK.
Bonaventura Clotet
Margaret Johnson
Matthias Stoll
Nicholas Bellos
Erik Smets
Hospital Universitari Germans Trias i Pujol · ESInfectious Disease Consultants · USUniversity College London · GBUniversity of Liverpool · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVery few studies have evaluated the cost of highly active antiretroviral therapy (HAART) per successful treatment in HIV-infected patients.

objectivesTo evaluate the cost of achieving undetectable plasma HIV-RNA levels in highly treatment-experienced, HIV-1-infected adults receiving darunavir/ritonavir (DRV/r 600 mg/100 mg twice a day) or control protease inhibitor (PI)-based HAART.

methodsThe mean annual per-patient cost of DRV/r and control PI-based HAART was determined from the proportional use of antiretroviral agents in the DRV/r and control PI arms of the pooled POWER 1 and 2 trials, applying drug acquisition costs for 13 healthcare settings. The mean annual cost per patient of achieving undetectable plasma HIV-RNA levels (<50 copies/mL) was calculated by dividing the cost of each treatment by the proportion of patients with undetectable plasma HIV-RNA levels after 48 weeks in the DRV/r (45%) and control PI (10%) arms of the POWER trials.

resultsWhereas absolute costs of treatment were 1-19% higher with DRV/r versus control PI-based HAART depending on the healthcare setting, the mean annual per-patient cost of achieving undetectable plasma HIV-RNA levels was 73-78% lower. These cost savings were maintained in the sensitivity analyses, adjusting for control PI and enfuvirtide use, and the number of active drugs in the background regimen. The incremental annual cost per additional patient achieving undetectable plasma HIV-RNA levels with DRV/r versus control PI-based HAART in POWER 1 and 2 (£4148) compared favourably with that determined for enfuvirtide (£137, 740; TORO trials) and tipranavir/ritonavir (£32,176; RESIST) versus control therapy.

conclusionsDRV/r-based HAART provided consistent reductions in the cost of achieving undetectable plasma HIV-RNA levels compared with control PI-based therapy in highly treatment-experienced patients across various healthcare settings. The incremental cost per additional patient achieving undetectable plasma HIV-RNA levels with DRV/r versus control PI-based HAART was also lower than that calculated for other treatment options in this population. These results suggest that DRV/r is an economically viable option for highly treatment-experienced patients.

Indexed as

Drug CostsHIV-1Anti-HIV AgentsAntiretroviral Therapy, Highly ActiveDarunavirEuropeFemaleHIV InfectionsHIV Protease InhibitorsHumansMaleProtease InhibitorsReverse Transcriptase InhibitorsRitonavirRNA, ViralSulfonamidesAnti-HIV AgentsDarunavirHIV Protease InhibitorsProtease InhibitorsReverse Transcriptase InhibitorsRitonavirRNA, ViralSulfonamides

Identifiers

PMID21182345
OpenAlexW2002081620

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.