HIV Cure Strategies: How Good Must They be to Improve on ART?
2014
This article uses a microsimulation model to explore under what circumstances three HIV cure strategies (gene therapy, chemotherapy and stem cell transplantation (SCT)) would improve efficacy, toxicity, cost and quality of life outcomes compared to current antiretroviral therapy (ART).
Assuming a cost-effectiveness threshold of $100,000 per QALY, results show that gene therapy was cost-effective compared to ART with an efficacy of 10%, relapse rate of 0.5%/month, and cost of $54,000. Chemotherapy was cost-effective with an efficacy of 88%, relapse rate of 0.5%/month, and cost of $12,400/month for 24 months. At $150,000/procedure, SCT was cost-effective with efficacy of 79% and relapse rate 0.5%/month. Moderate efficacy increases and cost reductions made gene therapy cost-saving, but substantial efficacy/cost changes were needed to make chemotherapy or SCT cost-saving.
The authors conclude that under different scenarios of efficacy, relapse rate, and cost the three HIV cure strategies could be more cost-effective compared with ART and even cost-saving.
HIV Cure Strategies: How Good Must They be to Improve on ART?
Source:
Sax PE, Sypek A, Kerowitz BK, Morris BL, Losina E, Paltiel D, Kelly KA, Seage GR, Walensky RP, Weinstein MC, Eron J, Freedberg KA. HIV Cure Strategies: How Good Must They Be to Improve on Current Antiretroviral Therapy? PLOS ONE 2014; 9 (11). https://doi.org/10.1371/journal.pone.0113031