Lee T A, Sullivan S D, Veenstra D L, Ramsey S D, Steger P J, Malinverni R, Pleil A M, Williamson T
Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle 98195, USA.
Pharmacoeconomics. 2001;19(5 Pt 2):535-50. doi: 10.2165/00019053-200119050-00008.
To determine the cost of using systemic therapy to treat newly diagnosed cytomegalovirus (CMV) retinitis in persons with AIDS.
Incidence-based simulation model of CMV treatment from a government payer perspective.
Swiss healthcare system.
Patients with AIDS and newly diagnosed CMV retinitis.
Patients were assigned to 1 of 4 treatment regimens for induction and maintenance therapy: (i) intravenous (IV) cidofovir induction and maintenance (cidofovir IV/IV); (ii) IV foscarnet induction and maintenance (foscarnet IV/IV); (iii) IV ganciclovir induction and maintenance (ganciclovir IV/IV); and (iv) IV ganciclovir induction and oral (PO) ganciclovir maintenance (ganciclovir IV/PO). Following a second relapse, patients were assigned to one of the other regimens.
Time to first and subsequent progression, duration of maintenance treatment and direct medical expenditures [1998 Swiss francs (SwF)] .
The median time to first progression was longest for cidofovir IV/IV, followed by foscarnet IV/IV, ganciclovir IV/IV and ganciclovir IV/PO. Mean survival was 13 months and mean costs for this period in the base case were lowest in those initially treated with cidofovir (SwF146,742), followed by initial treatment with foscarnet IV/IV (SwF194,809), ganciclovir IV/PO (SwF195,190) and ganciclovir IV/IV (SwF243,964). Costs were most sensitive to changes in efficacy estimates.
Of the regimens studied, initiation of treatment with systemic cidofovir appears least costly over a 13-month period.
确定使用全身治疗方法治疗艾滋病患者新诊断的巨细胞病毒（CMV）视网膜炎的成本。
从政府支付方角度建立的基于发病率的CMV治疗模拟模型。
瑞士医疗体系。
患有艾滋病且新诊断为CMV视网膜炎的患者。
患者被分配到4种诱导和维持治疗方案中的1种：（i）静脉注射（IV）西多福韦诱导和维持治疗（西多福韦IV/IV）；（ii）静脉注射膦甲酸钠诱导和维持治疗（膦甲酸钠IV/IV）；（iii）静脉注射更昔洛韦诱导和维持治疗（更昔洛韦IV/IV）；以及（iv）静脉注射更昔洛韦诱导和口服（PO）更昔洛韦维持治疗（更昔洛韦IV/PO）。第二次复发后，患者被分配到其他方案之一。
首次及后续病情进展时间、维持治疗持续时间和直接医疗费用[1998瑞士法郎（SwF）]。
西多福韦IV/IV方案首次病情进展的中位时间最长，其次是膦甲酸钠IV/IV、更昔洛韦IV/IV和更昔洛韦IV/PO。平均生存期为13个月，在基础病例中，这一期间的平均费用在最初接受西多福韦治疗的患者中最低（146,742瑞士法郎），其次是最初接受膦甲酸钠IV/IV治疗（194,809瑞士法郎）、更昔洛韦IV/PO治疗（195,190瑞士法郎）和更昔洛韦IV/IV治疗（243,964瑞士法郎）。费用对疗效估计的变化最为敏感。
在所研究的方案中，在13个月期间开始使用全身西多福韦治疗似乎成本最低。
