Evidence map›Paper›PMID 25285019›Full record

ArticleClinicoEconomics and outcomes research : CEOR2014

Budget impact analysis of antiretroviral less drug regimen simplification in HIV-positive patients on the Italian National Health Service.

Umberto Restelli, Massimo Andreoni, Andrea Antinori, Marzia Bonfanti, Giovanni Di Perri, Massimo Galli, Adriano Lazzarin, Giuliano Rizzardini, Davide Croce

Open access · goldAbstract read
In one paragraph

Article in ClinicoEconomics and outcomes research : CEOR, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 24% 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

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
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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

9 authors at 7 institutions in 2 countries.

Umberto RestelliDepartment of Community Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ; Centro di Ricerca in Economia e Management in Sanità e nel Sociale (CREMS), Università Carlo Cattaneo - LIUC, Castellanza (VA), Italy.
Massimo AndreoniClinical Infectious Diseases, Tor Vergata University (PTV), Rome, Italy.
Andrea AntinoriClinical Department, National Institute for Infectious Diseases "L. Spallanzani," Rome, Italy.
Marzia BonfantiCentro di Ricerca in Economia e Management in Sanità e nel Sociale (CREMS), Università Carlo Cattaneo - LIUC, Castellanza (VA), Italy.
Giovanni Di PerriDepartment of Medical Sciences, Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy.
Massimo GalliThird Division of Infectious Diseases, "Luigi Sacco" Hospital, Milan, Italy.
Adriano LazzarinDepartment of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy.
Giuliano RizzardiniFirst and Second Divisions of Infectious Diseases, "Luigi Sacco" Hospital, Milan, Italy ; School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Davide CroceDepartment of Community Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ; Centro di Ricerca in Economia e Management in Sanità e nel Sociale (CREMS), Università Carlo Cattaneo - LIUC, Castellanza (VA), Italy.
University Carlo Cattaneo · ITUniversity of the Witwatersrand · ZAIstituto Nazionale per le Malattie Infettive Lazzaro Spallanzani · ITLuigi Sacco Hospital · ITOspedale Amedeo di Savoia · ITSan Raffaele University of Rome · ITUniversity of Rome Tor Vergata · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDeintensification and less drug regimen (LDR) antiretroviral therapy (ART) strategies have proved to be effective in terms of maintaining viral suppression in human immunodeficiency virus (HIV)-positive patients, increasing tolerability, and reducing toxicity of antiretroviral drugs administered to patients. However, the economic impact of these strategies have not been widely investigated. The aim of the study is to evaluate the economic impact that ART LDR could have on the Italian National Health Service (INHS) budget.

methodsA budget impact model was structured to assess the potential savings for the INHS by the use of ART LDR for HIV-positive patients with a 3 year perspective. Data concerning ART cost, patient distribution within different ARTs, and probabilities for patients to change ART on a yearly basis were collected within four Italian infectious diseases departments, providing ART to 13.7% of the total number of patients receiving ART in Italy.

resultsThe LDR investigated (protease inhibitor-based dual and monotherapies) led to savings for the hospitals involved when compared to the "do nothing" scenario on a 3 year basis, between 6.7% (23.11 million €) and 12.8% (44.32 million €) of the total ART expenditures. The mean yearly cost per patient is reduced from 9,875 € in the do nothing scenario to a range between 9,218 € and 8,615 €. The use of these strategies within the four departments involved would have led to a reduction of ART expenditures for the INHS of between 1.1% and 2.1% in 3 years.

conclusionART LDR simplification would have a significant impact in the reduction of ART-related costs within the hospitals involved in the study. These strategies could therefore be addressed as a sustainable answer to the public financing reduction observed within the INHS in the last year, allowing therapies to be dispensed without affecting the quality of the services provided.

Indexed as

antiretroviral therapybudget impact modelcostdual therapyItalymonotherapy

Identifiers

PMID25285019
PMCPMC4181445
OpenAlexW2040903445

What OpenQuestion holds

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Registered trials

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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.