Desyatnik M, Baaj A; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. MoPeC2477.
M. Desyatnik, Beth Israel Deaconess Medical Center, Pharmacy Department (Baker 5), One Deaconess Road, Boston, Massachusetts 02215, United States, Tel.: +1 617 632 89 73, Fax: +1 617 632 70 24, E-mail: mdesyatn@caregroup.harvard.edu
Background: Both anabolic steroids and recombinant human growth hormone (rhGH) are used in the management of AIDS Wasting Syndrome (AWS), yet the more cost-effective treatment remains unknown. Objective: Compare the cost-effectiveness of rhGH (Serostim) and oxandrolone (Oxandrin) in the treatment of AWS from a third party payer perspective. Methods: A decision analytic model was developed to compare the cost and efficacy of both rhGH at 6 mg daily and oxandrolone 20 mg daily. Probabilities for each decision pathway were derived by pooled meta-analysis of published clinical trials of patients with AWS. The primary efficacy endpoint was gain in lean body mass (LBM) at the end of a treatment cycle. Costs included drug acquisition (average wholesale price) and failure of therapy (derived from published literature). Results: In a simple efficacy analysis, rhGH was 6.5 times more effective than oxandrolone (2.14 vs. 0.32 kg of LBM gained, respectively). Despite its higher acquisition price, the cost-effectiveness (CE) ratio for rhGH was consistently more favorable than that of oxandrolone in the various analyses. In a four month cost analysis, the CE ratio of rhGH was 2 times more favorable than that of oxandrolone ($8,571 vs. $19,553 per kg of LBM gained, respectively). In a one year cost analysis, the CE ratio of rhGH was 6 times more favorable than that of oxandrolone ($11,598 vs. $70,695 per kg of LBM gained, respectively). Conclusion: In an era of cost containment, it is key to consider the total cost of treatment including, not only, drug purchase price but also the associated costs of toxicities and treatment failure. Due to its high efficacy and low treatment failure, recombinant human growth hormone is a more cost-effective treatment of AWS when compared to oxandrolone.
Publication Types:
Keywords:
- Cost-Benefit Analysis
- Costs and Cost Analysis
- HIV Wasting Syndrome
- Human Growth Hormone
- Humans
- Oxandrolone
- economics
- therapy
Other ID:
UI: 102238132
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