UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Five-Year Trends in Antiretroviral Usage and Drug Costs in HIV-Infected Children in Thailand

Collins, I; Cairns, J; Le Coeur, S; Pagdi, K; Ngampiyaskul, C; Layangool, P; Borkird, T; ... Lallemant, M; + view all (2013) Five-Year Trends in Antiretroviral Usage and Drug Costs in HIV-Infected Children in Thailand. JAIDS Journal of Acquired Immune Deficiency Syndromes , 64 (1) 95 - 102. 10.1097/QAI.0b013e318298a309. Green open access

[thumbnail of Collins et al. Five year trends in ARV usage and drug cost in children - Final submitted.pdf]
Preview
Text
Collins et al. Five year trends in ARV usage and drug cost in children - Final submitted.pdf
Available under License : See the attached licence file.

Download (211kB)

Abstract

Background: As antiretroviral treatment (ART) programs mature, data on drug utilization and costs are needed to assess durability of treatments and inform program planning. Methods: Children initiating ART were followed up in an observational cohort in Thailand. Treatment histories from 1999 to 2009 were reviewed. Treatment changes were categorized as: drug substitution (within class), switch across drug class (non nucleoside reverse-transcriptase inhibitors (NNRTI) to/from protease inhibitor (PI)), and to salvage therapy (dual PI or PI and NNRTI). Antiretroviral drug costs were calculated in 6-month cycles (US$ 2009 prices). Predictors of high drug cost including characteristics at start of ART (baseline), initial regimen, treatment change, and duration on ART were assessed using mixed-effects regression models. Results: Five hundred seven children initiated ART with a median 54 (interquartile range, 36–72) months of follow-up. Fifty-two percent had a drug substitution, 21% switched across class, and 2% to salvage therapy. When allowing for drug substitution, 78% remained on their initial regimen. Mean drug cost increased from $251 to $428 per child per year in the first and fifth year of therapy, respectively. PI-based and salvage regimens accounted for 16% and 2% of treatments prescribed and 33% and 5% of total costs, respectively. Predictors of high cost include baseline age >= 8 years, non nevirapine-based initial regimen, switch across drug class, and to salvage regimen (P < 0.005). Conclusions: At 5 years, 21% of children switched across drug class and 2% received salvage therapy. The mean drug cost increased by 70%. Access to affordable second- and third-line drugs is essential for the sustainability of treatment programs.

Type: Article
Title: Five-Year Trends in Antiretroviral Usage and Drug Costs in HIV-Infected Children in Thailand
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAI.0b013e318298a309
Publisher version: http://dx.doi.org/10.1097/QAI.0b013e318298a309
Language: English
Additional information: This is a non-final version of an article published in final form in Collins, I; Cairns, J; Le Coeur, S; Pagdi, K; Ngampiyaskul, C; Layangool, P; Borkird, T; (2013) Five-Year Trends in Antiretroviral Usage and Drug Costs in HIV-Infected Children in Thailand. JAIDS Journal of Acquired Immune Deficiency Syndromes , 64 (1) 95 - 102. 10.1097/QAI.0b013e318298a309.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/1451375
Downloads since deposit
2,454Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item