@article{fdi:010077902,
  title = {{C}ost-effectiveness analysis of {L}opinavir/{R}itonavir monotherapy versus standard combination antiretroviral therapy in {HIV}-1 infected patients with viral suppression in {F}rance ({ANRS} 140 {DREAM})},
  author = {{G}aray, {O}. {U}. and {N}ishimwe, {M}. {L}. and {B}ousmah, {M}. {A}. {Q}. and {J}anah, {A}. and {G}irard, {P}. {M}. and {C}hene, {G}. and {M}oinot, {L}. and {S}agaon {T}eyssier, {L}uis and {M}eynard, {J}. {L}. and {S}pire, {B}. and {B}oyer, {S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {P}rotease inhibitor monotherapy is a simplified treatment strategy for virally suppressed {HIV}-positive patients that has the potential for cost savings, as fewer drugs are used than with combination therapy. {H}owever, evidence for its economic value is limited. {O}bjectives {W}e assessed the cost-effectiveness of lopinavir/ritonavir monotherapy followed by treatment intensification in case of viral load rebound versus combination antiretroviral therapy (c{ART}) with efavirenz/emtricitabine/tenofovir in {HIV}-1 infected patients with viral suppression in the {ANRS} 140 {DREAM} trial. {M}ethods {DREAM} was conducted in 36 {F}rench {H}ospitals between 2009 and 2013. {F}or each treatment strategy, we estimated the unadjusted and multivariate-adjusted mean costs (in (sic), year 2010 values) and quality-adjusted life-years ({QALY}s) per patient, as well as incremental costs and {QALY}s per patient. {W}e then assessed uncertainty using the cost-effectiveness acceptability curve, scenario analyses and cost-effectiveness price-threshold ({CEPT}) analysis. {R}esults {I}n the base-case analysis considering 2009-2013 antiretroviral drug ({ARV}) prices, adjusted incremental costs and {QALY}s were - (sic)3296 (95% confidence interval [{CI}] - 5202 to - 1391) and 0.006 (95% {CI} - 0.021 to 0.033), respectively, over 2 years, suggesting that monotherapy was cost-effective with a probability of 100% at various cost-effectiveness thresholds. {I}n scenario analyses considering 2018 {ARV} prices, monotherapy remained cost-effective but with a lower probability (94% vs. 100% in the base-case analysis). {T}he current price of c{ART} would have to decrease by 34% to be cost-effective with a probability of 95%. {C}onclusion {M}onotherapy appears to be cost-effective compared with c{ART} for virologically suppressed {HIV}-positive patients in {F}rance. {CEPT} analysis is a useful tool to identify the preferred strategy to adopt given that {ARV} prices change rapidly.},
  keywords = {{FRANCE}},
  booktitle = {},
  journal = {{P}harmacoeconomics : {O}pen},
  volume = {3},
  numero = {4},
  pages = {505--515},
  ISSN = {2509-4262},
  year = {2019},
  DOI = {10.1007/s41669-019-0130-7},
  URL = {https://www.documentation.ird.fr/hor/fdi:010077902},
}