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The cost-effectiveness analysis of single-tablet efavirenz-based regimen among HIV-1 infected adults in China

Bibliographic Data

ID22076326
AuthorsHaijun Zhang (0000-0002-0236-6482, Johns Hopkins University), Yuhao Kong (Vanke (China)), Haotian Chen (0000-0002-2816-6403, Vanke (China)), Sitong Luo (0000-0002-7450-5613, Vanke (China)), Pengyang Fan (0000-0003-4354-6524, Vanke (China), corresponding author), Zhihui Li (0000-0001-5356-932X), Z B Li (0000-0003-0208-9523, Vanke (China), corresponding author)
Year2025
Volume13
Pages1429461-1429461
Publication date2025-05-08
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1429461
PMID40406087
OpenAlexW4410185709
LanguageEN
Citations received2
References cited30

Introduction: In 2018, the Chinese Guidelines for Diagnosis and Treatment of HIV/AIDS recommended the adoption of the efavirenz 400 mg-based TLE (tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) + efavirenz (EFV)) regimen as the primary first-line treatment for ART-naive HIV-1 infected adults in China. However, the cost-effectiveness of different TLE treatment strategies remains uncertain. This study aimed to evaluate the cost-effectiveness of various TLE treatment strategies for ART-naive HIV-1 infected adults in China. Methods: A decision-tree Markov state transition model was employed to assess the cost-effectiveness of various TLE treatment strategies over a 10-year timeframe, from a societal perspective. Input parameters were obtained from published literature and publicly accessible information. Local data from the latest sources were used as input parameters whenever possible. The main outcome measure was the incremental costs per quality-adjusted life years (QALYs) gained. Sensitivity analyses were performed to investigate model uncertainties and determine break-even prices. Results: Compared to the multiple-tablet regimen (MTR) consisting of efavirenz 400 mg-based TLE (TLE400) and efavirenz 600 mg-based TLE (TLE600), the single-tablet regimen (STR) of TLE400 exhibited a 10-year cost of 130733.8 CNY (compared to 122939.7 CNY and 126184.3 CNY, respectively) and an expected QALYs of 6.45 (compared to 6.27 QALYs and 6.32 QALYs, respectively) per HIV-1 patient in China. Consequently, the incremental cost-effectiveness ratios (ICERs) were 41021.6 CNY/QALY gained (equivalent to US$ 6071.2 per QALY gained) and 34996.2 CNY/QALY gained (equivalent to US$ 5179.4 per QALY gained) for TLE400 STR compared to TLE400 MTR and TLE600 MTR, respectively. The ICER for TLE400 MTR compared to TLE600 MTR was 54076.7 CNY/QALY gained (equivalent to US$ 8003.4 per QALY gained). Deterministic sensitivity analysis indicated that adherence rates to ART had the most significant influence on all three strategies. In probabilistic sensitivity analysis, TLE400 STR demonstrated a 71.4% probability of being highly cost-effective nationwide, based on the one-time national-level GDP per capita. Conclusion: In the context of treating HIV-1 infected adults in China, the STR of TLE400 demonstrated cost-effectiveness when compared to both the MTR of TLE400 and the MTR of TLE600

Antiretroviral therapy · China · Efavirenz · Geography · Regimen · Viral load · HIV Research and Treatment · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions · Medicine · Internal Medicine · Virology

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Citations per year2
Citation span2025 - 2026 (2)
Highly citedNo

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