@article{fdi:010077924,
  title = {{C}ost-effectiveness of three alternative boosted {P}rotease inhibitor-based second-line regimens in {HIV}-infected patients in {W}est and {C}entral {A}frica},
  author = {{B}oyer, {S}. and {N}ishimwe, {M}. {L}. and {S}agaon {T}eyssier, {L}uis and {M}arch, {L}aura and {K}oulla-{S}hiro, {S}. and {B}ousmah, {M}. {Q}. and {T}oby, {R}. and {M}poudi-{E}tame, {M}. {P}. and {G}ueye, {N}. {F}. {N}. and {S}awadogo, {A}. and {K}ouanfack, {C}. and {C}iaffi, {L}. and {S}pire, {B}. and {D}elaporte, {E}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {W}hile dolutegravir has been added by {WHO} as a preferred second-line option for the treatment of {HIV} infection, boosted protease inhibitor (b{PI})-based regimens are still needed as alternative second-line options. {I}dentifying optimal b{PI}-based second-line combinations is essential, given associated high costs and funding constraints in low- and middle-income countries. {W}e assessed the cost-effectiveness of three alternative b{PI}-based second-line regimens in {B}urkina {F}aso, {C}ameroon and {S}enegal. {M}ethods {W}e used data collected over 2010-2015 in the 2{LADY} trial/post-trial cohort. {P}atients with first-line antiretroviral therapy ({ART}) failure were randomly assigned to tenofovir/emtricitabine + lopinavir/ritonavir ({TDF}/{FTC} {LPV}/r; arm {A}), abacavir + didanosine + lopinavir/ritonavir (arm {B}), or tenofovir/emtricitabine + darunavir/ritonavir (arm {C}). {C}osts ({US} dollars, 2016), quality-adjusted life-years ({QALY}s) and incremental cost-effectiveness ratios were computed for each country over 24 months of follow-up and extrapolated to 5 years using a simulated patient-level {M}arkov model. {W}e assessed uncertainty using cost-effectiveness acceptability curves, scenarios and prices threshold analysis. {R}esults {I}n each country, over 24 months, arm {A} was significantly less costly than arms {B} and {C} (incremental costs ranging from {US}$410-${US}721 and {US}$468-{US}$546 for {B} and {C} vs {A}, respectively) and offered similar health benefits (incremental {QALY}: - 0.138 to 0.023 and - 0.179 to 0.028, respectively). {O}ver 5 years, arm {A} remained the least costly, health benefits not being significantly different between arms. {C}ompared with arms {B} and {C}, in each study country, {A}rm {A} had a >= 95% probability of being cost-effective for a large range of cost-effectiveness thresholds, irrespective of the scenario considered. {C}onclusions {U}sing {TDF}/{FTC} {LPV}/r as a b{PI}-based second-line regimen provided the best economic value in the three study countries.},
  keywords = {{BURKINA} {FASO} ; {CAMEROUN} ; {SENEGAL}},
  booktitle = {},
  journal = {{P}harmacoeconomics-{O}pen},
  volume = {4},
  numero = {1},
  pages = {45--60},
  ISSN = {2509-4262},
  year = {2020},
  DOI = {10.1007/s41669-019-0157-9},
  URL = {https://www.documentation.ird.fr/hor/fdi:010077924},
}