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01-05-2007 | Original Research Article

Economic Evaluation of Treatment Administration Strategies of Ganciclovir for Cytomegalovirus Retinitis in HIV/AIDS Patients in Thailand

A Simulation Study

Authors: Kanlaya Teerawattananon, Saniorn Iewsakul, Chawewan Yenjitr, Somsanguan Ausayakhun, Watanee Yenjitr, Miranda Mugford, Yot Teerawattananon

Published in: PharmacoEconomics | Issue 5/2007

Abstract

Background

There are many effective interventions, via various routes (intravenous [IV], oral [OR], intravitreal injection [IVT] and intraocular implantation [IMP]), for treating cytomegalovirus retinitis (CMVR) that have become available. There are large variations in treating CMVR in clinical practice in Thailand.

Objective

To evaluate the incremental cost-effectiveness ratio (ICER) of providing (i) IVT, (ii) IV/OR and (iii) IMP ganciclovir to patients with HIV/AIDS and CMVR versus providing no treatment.

Design

A simulation study for which the input parameters were derived from a systematic review of the literature, a hospital-based survey and patient interviews.

Setting

The analysis assumed a Thai healthcare system perspective. However, the model was run using both societal and healthcare provider perspectives.

Results

Our results suggest that IVT ganciclovir was cost effective and the best option for treating patients with CMVR irrespective of whether patients received antiretroviral treatment (ART). In patients receiving ART, moving from IVT to IV/OR ganciclovir was also likely to be a cost-effective option. Offering IMP ganciclovir was not likely to be cost effective. Providing treatments for patients with bilateral CMVR was more cost effective than providing treatments for those with unilateral CMVR, and offering treatments for patients receiving ART was better value for money than treating patients without ART.

Conclusions

Our models suggest that IV/OR ganciclovir should be recommended for the treatment of unilateral and bilateral CMVR for patients receiving ART in the Thai healthcare system. IVT ganciclovir may also have a role in the treatment of CMVR patients not receiving ART.

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Title: Economic Evaluation of Treatment Administration Strategies of Ganciclovir for Cytomegalovirus Retinitis in HIV/AIDS Patients in Thailand
A Simulation Study
Authors: Kanlaya Teerawattananon
Saniorn Iewsakul
Chawewan Yenjitr
Somsanguan Ausayakhun
Watanee Yenjitr
Miranda Mugford
Yot Teerawattananon
Publication date: 01-05-2007
Publisher: Springer International Publishing
Published in: PharmacoEconomics / Issue 5/2007
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI: https://doi.org/10.2165/00019053-200725050-00005

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Economic Evaluation of Treatment Administration Strategies of Ganciclovir for Cytomegalovirus Retinitis in HIV/AIDS Patients in Thailand

A Simulation Study

Abstract

Background

Objective

Design

Setting

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Design

Setting

Results

Conclusions

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