Early ART Cost-Effective in HIV-Serodiscordant Couples
(HealthDay News) – In South Africa and India, early antiretroviral therapy (ART) is projected to be cost-effective over a lifetime for HIV-serodiscordant couples, according to a study published in the Oct. 31 issue of the New England Journal of Medicine.
Rochelle P. Walensky, MD, MPH, from Massachusetts General Hospital in Boston, and colleagues used a computer simulation of HIV progression and data from the HIV Prevention Trials Network 052 study to examine the cost-effectiveness of early ART compared with delayed ART for serodiscordant couples in South Africa and India. Early ART was classified as very cost-effective, cost-effective, or cost-saving, compared with delayed ART.
The researchers found that over a five-year period early ART prevented opportunistic disease and was cost saving in South Africa, and it was very cost-effective over a lifetime ($590 per life-year saved). Early ART was cost-effective over a five-year period ($1,800 per life-year saved) and was very cost-effective ($530 per life-year saved) over a lifetime in India. In both countries, over short periods, early ART prevented HIV transmission, but this effect was attenuated by longer survival. Clinical benefit for treated patients was the main driver of life-years saved. Under most modeled assumptions in the two countries, early ART remained very cost-effective.
"With individual, public health, and economic benefits, there is a compelling case for early ART for serodiscordant couples in resource-limited settings," the authors write.
Several pharmaceutical companies donated the study drugs for the HPTN 052 trial.