@article{fdi:010089016,
  title = {{C}ost-utility analysis of a {D}olutegravir-based versus low-dose {E}favirenz-based regimen for the initial treatment of {HIV}-infected patients in {C}ameroon ({NAMSAL} {ANRS} 12313 {T}rial)},
  author = {{B}ousmah, {M}arwan-al-{Q}ays and {N}ishimwe, {M}.{L}. and {T}ovar-{S}anchez, {T}. and {W}andji, {M}.{L}. and {M}poudi-{E}tame, {M}. and {M}aradan, {G}. and {B}assega, {P}.{O}. and {V}arloteaux, {M}. and {M}ontoyo, {A}. and {K}ouanfack, {C}. and {D}elaporte, {E}. and {B}oyer, {S}ylvie},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives {E}vidence comparing the economic and patient values of the {W}orld {H}ealth {O}rganization's preferred (dolutegravir 50 mg [{DTG}]-based) and alternative (low-dose [400 mg] efavirenz [{EFV}400]-based) first-line antiretroviral regimens is limited. {W}e compared patient-reported outcomes ({PRO}s), costs, and the cost-utility of {DTG}- versus {EFV}400-based regimens in treatment-naive {HIV}-1 adults in the randomised {NAMSAL} {ANRS} 12313 trial in {Y}aounde, {C}ameroon. {M}ethods {W}e used clinical data, {PRO}s, and health resource use data collected in the trial's first 96 weeks (2016-2019). {Q}uality-adjusted life-years ({QALY}s) were computed using utility scores obtained from the 12-item {S}hort {F}orm ({SF}-12) generic health scale. {O}ther {PRO}s included perceived symptoms, depression, anxiety, and stress. {I}n the 96-week base-case analysis, we estimated the unadjusted and multivariate-adjusted (1) mean costs (in {US}$, 2016 values) and {QALY}s/patient, (2) incremental costs and {QALY}s/patient, and (3) net health benefit ({NHB}). {O}utcomes were extrapolated over 5 and 10 years. {U}ncertainty was assessed using the cost-effectiveness acceptability curve and scenario and cost-effective price threshold analyses. {R}esults {I}n the base-case analysis, the {NHB} (95% confidence interval) for the {DTG}-based regimen relative to the {EFV}400-based regimen was 0.056 (- 0.037 to 0.153), corresponding to an 88% probability of {DTG} being cost-effective. {A} 10% decrease in this regimen's price (from $5.2 to $4.7/month) would increase its cost-effectiveness probability to 95%. {W}hen extrapolating outcomes over 5 and 10 years, the {DTG}-based regimen had a 100% probability of being cost-effective for a large range of cost-effectiveness thresholds. {C}onclusions {A}t 2020 antiretroviral drug prices, a {DTG}-based first-line regimen should be preferred over an {EFV}400-based regimen in sub-{S}aharan {A}frica.},
  keywords = {{CAMEROUN}},
  booktitle = {},
  journal = {{P}harmaceconomics},
  volume = {39},
  numero = {3},
  pages = {331--343},
  ISSN = {1170-7690},
  year = {2021},
  DOI = {10.1007/s40273-020-00987-3},
  URL = {https://www.documentation.ird.fr/hor/fdi:010089016},
}