University of Toulouse III, 31330, Toulouse, France.
Health Economics Unit, Medical Information Department, University Hospital of Toulouse, Toulouse, France.
BMC Health Serv Res. 2022 Apr 27;22(1):567. doi: 10.1186/s12913-022-07859-w.
In a context where the economic burden of HIV is increasing as HIV patients now have a close to normal lifespan, the availability of generic antiretrovirals commonly prescribed in 2017 and the imminence of patent expiration are expected to provide substantial savings in the coming years. This article aims to assess the economic impact of these generic antiretrovirals in France and specifically over a five-year period.
An agent-based model was developed to simulate patient trajectories and treatment use over a five-year period. By comparing the results of costs for trajectories simulated under different predefined scenarios, a budget impact model can be created and sensitivity analyses performed on several parameters of importance.
The potential economic savings from 2019 to 2023 generated by generic antiretrovirals range from €309 million when the penetration rate of generics is set at 10% to €1.5 billion at 70%. These savings range from €984 million to €993 million as the delay between patent and generic marketing authorisation varies from 10 to 15 years, and from €965 million to €993 million as the Negotiated Price per Unit (NPU) of generics at market-entry varies from 40 to 50% of the NPU for patents.
This economic savings simulation could help decision makers to anticipate resource allocations for further innovation in antiretrovirals therapies as well as prevention, especially by funding the Pre-Exposure Prophylaxis (PrEP) or HIV screening.
随着 HIV 患者的预期寿命接近正常，HIV 的经济负担不断增加，2017 年普遍开处的仿制药的供应以及专利即将到期，预计未来几年将节省大量资金。本文旨在评估这些仿制药在法国的经济影响，特别是在未来五年内的影响。
开发了基于代理的模型来模拟患者在五年内的轨迹和治疗使用情况。通过比较在不同预设场景下模拟轨迹的成本结果，可以创建预算影响模型，并对几个重要参数进行敏感性分析。
从 2019 年到 2023 年，仿制药的潜在经济节省范围从渗透率设定为 10%时的 3.09 亿欧元到 70%时的 15 亿欧元。这些节省范围从专利和仿制药上市授权之间的延迟从 10 年到 15 年变化时的 9.84 亿欧元到 9.93 亿欧元不等，从通用产品的每单位谈判价格 (NPU) 从专利的 40%到 50%变化时的 9.65 亿欧元到 9.93 亿欧元不等。
这种经济节省模拟可以帮助决策者预测抗逆转录病毒疗法以及预防方面的资源分配，特别是通过为暴露前预防 (PrEP) 或 HIV 筛查提供资金。
