(HealthDay News) – The use of first-line, generic-based antiretroviral (ART) HIV treatment in the United States could potentially save almost $1 billion in the first year of implementation, according to a study published in the Jan. 15 issue of the Annals of Internal Medicine.

Rochelle P. Walensky, MD, MPH, from Massachusetts General Hospital in Boston, and colleagues conducted a mathematical simulation study for HIV-infected individuals in the United States to assess the clinical effect, costs, and cost-effectiveness of a three-pill (efavirenz, lamivudine, tenofovir), generic-based regimen compared to a branded, co-formulated regimen. The potential national savings in the first year of a switch to generic-based ART were projected.

The researchers found that generic-based ART had an incremental cost-effectiveness ratio (ICER) of $21,100 per quality-adjusted life-year (QALY), compared with no ART. Branded ART increased lifetime costs by $42,500, vs. generic ART, and per-person survival gains by 0.37 QALYs, for an ICER of $114,800/QALY. If all eligible U.S. patients started or switched to generic-based ART, the estimated first-year savings would be $920 million. Branded ART ICERs were estimated to be greater than $100,000/QALY based on plausible assumptions about generic-based ART efficacy and costs.

“Compared with a slightly less effective generic-based regimen, the cost-effectiveness of first-line branded ART exceeds $100,000/QALY,” the authors write. “Generic-based ART in the United States could yield substantial budgetary savings to HIV programs.”

One author disclosed financial ties to the pharmaceutical industry.

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