Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort
BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim...
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| Veröffentlicht in: | PloS one 2011-09, Vol.6 (9), p.e23946-e23946 |
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| creator | Stoll, Matthias Kollan, Christian Bergmann, Frank Bogner, Johannes Faetkenheuer, Gerd Fritzsche, Carlos Hoeper, Kirsten Horst, Heinz-August van Lunzen, Jan Plettenberg, Andreas Reuter, Stefan Rockstroh, Jürgen Stellbrink, Hans-Jürgen Hamouda, Osamah Bartmeyer, Barbara |
| description | BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios.
Antiretroviral regimens (ART) from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC)-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes.
During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70). Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively). Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%.
Analysis of the data of this nationwide study reflects disease-specific health services research and will give insights into the cost impacts of antiretroviral therapy, and might allow a more rational allocation of resources within the German health care system. |
| doi_str_mv | 10.1371/journal.pone.0023946 |
| format | Article |
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Antiretroviral regimens (ART) from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC)-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes.
During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70). Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively). Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%.
Analysis of the data of this nationwide study reflects disease-specific health services research and will give insights into the cost impacts of antiretroviral therapy, and might allow a more rational allocation of resources within the German health care system.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0023946</identifier><identifier>PMID: 21931626</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adult ; AIDS ; Analysis ; Anti-HIV Agents - economics ; Anti-HIV Agents - pharmacology ; Anti-HIV Agents - therapeutic use ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Cohort Studies ; Cost analysis ; Cost engineering ; Cost reduction ; Cost Savings - statistics & numerical data ; Costs ; Data processing ; Disease control ; Drug Prescriptions - economics ; Drug Prescriptions - statistics & numerical data ; Drug Therapy, Combination - economics ; Drugs ; Drugs, Generic - economics ; Drugs, Generic - pharmacology ; Drugs, Generic - therapeutic use ; Economic aspects ; Female ; Follow-Up Studies ; Generic drugs ; Germany ; Health care ; Health services ; Highly active antiretroviral therapy ; HIV ; HIV Infections - drug therapy ; HIV Reverse Transcriptase - antagonists & inhibitors ; Human immunodeficiency virus ; Humans ; Male ; Medical research ; Medical treatment ; Medicine ; Pharmaceuticals ; Prescription drugs ; Protease inhibitors ; Protease Inhibitors - economics ; Protease Inhibitors - pharmacology ; Protease Inhibitors - therapeutic use ; Proteases ; Resource allocation ; Reverse Transcriptase Inhibitors - economics ; Reverse Transcriptase Inhibitors - pharmacology ; Reverse Transcriptase Inhibitors - therapeutic use ; Ritonavir ; Taxation ; Taxes ; Therapy</subject><ispartof>PloS one, 2011-09, Vol.6 (9), p.e23946-e23946</ispartof><rights>COPYRIGHT 2011 Public Library of Science</rights><rights>2011 Stoll et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Stoll et al. 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c691t-8f5abd79e606fdbac51381124a5e53689ea6fcb13bcd2d339aa248e7c0c8fcb63</citedby><cites>FETCH-LOGICAL-c691t-8f5abd79e606fdbac51381124a5e53689ea6fcb13bcd2d339aa248e7c0c8fcb63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170283/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170283/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23871,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21931626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Myer, Landon</contributor><creatorcontrib>Stoll, Matthias</creatorcontrib><creatorcontrib>Kollan, Christian</creatorcontrib><creatorcontrib>Bergmann, Frank</creatorcontrib><creatorcontrib>Bogner, Johannes</creatorcontrib><creatorcontrib>Faetkenheuer, Gerd</creatorcontrib><creatorcontrib>Fritzsche, Carlos</creatorcontrib><creatorcontrib>Hoeper, Kirsten</creatorcontrib><creatorcontrib>Horst, Heinz-August</creatorcontrib><creatorcontrib>van Lunzen, Jan</creatorcontrib><creatorcontrib>Plettenberg, Andreas</creatorcontrib><creatorcontrib>Reuter, Stefan</creatorcontrib><creatorcontrib>Rockstroh, Jürgen</creatorcontrib><creatorcontrib>Stellbrink, Hans-Jürgen</creatorcontrib><creatorcontrib>Hamouda, Osamah</creatorcontrib><creatorcontrib>Bartmeyer, Barbara</creatorcontrib><creatorcontrib>ClinSurv Study Group</creatorcontrib><creatorcontrib>and the ClinSurv Study Group</creatorcontrib><title>Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios.
Antiretroviral regimens (ART) from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC)-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes.
During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70). Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively). Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%.
Analysis of the data of this nationwide study reflects disease-specific health services research and will give insights into the cost impacts of antiretroviral therapy, and might allow a more rational allocation of resources within the German health care system.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Anti-HIV Agents - economics</subject><subject>Anti-HIV Agents - pharmacology</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Cohort Studies</subject><subject>Cost analysis</subject><subject>Cost engineering</subject><subject>Cost reduction</subject><subject>Cost Savings - statistics & numerical data</subject><subject>Costs</subject><subject>Data processing</subject><subject>Disease control</subject><subject>Drug Prescriptions - economics</subject><subject>Drug Prescriptions - statistics & numerical data</subject><subject>Drug Therapy, Combination - economics</subject><subject>Drugs</subject><subject>Drugs, Generic - economics</subject><subject>Drugs, Generic - pharmacology</subject><subject>Drugs, Generic - therapeutic use</subject><subject>Economic aspects</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Generic drugs</subject><subject>Germany</subject><subject>Health care</subject><subject>Health services</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Reverse Transcriptase - antagonists & inhibitors</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Pharmaceuticals</subject><subject>Prescription drugs</subject><subject>Protease inhibitors</subject><subject>Protease Inhibitors - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stoll, Matthias</au><au>Kollan, Christian</au><au>Bergmann, Frank</au><au>Bogner, Johannes</au><au>Faetkenheuer, Gerd</au><au>Fritzsche, Carlos</au><au>Hoeper, Kirsten</au><au>Horst, Heinz-August</au><au>van Lunzen, Jan</au><au>Plettenberg, Andreas</au><au>Reuter, Stefan</au><au>Rockstroh, Jürgen</au><au>Stellbrink, Hans-Jürgen</au><au>Hamouda, Osamah</au><au>Bartmeyer, Barbara</au><au>Myer, Landon</au><aucorp>ClinSurv Study Group</aucorp><aucorp>and the ClinSurv Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2011-09-09</date><risdate>2011</risdate><volume>6</volume><issue>9</issue><spage>e23946</spage><epage>e23946</epage><pages>e23946-e23946</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios.
Antiretroviral regimens (ART) from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC)-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes.
During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70). Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively). Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%.
Analysis of the data of this nationwide study reflects disease-specific health services research and will give insights into the cost impacts of antiretroviral therapy, and might allow a more rational allocation of resources within the German health care system.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>21931626</pmid><doi>10.1371/journal.pone.0023946</doi><tpages>e23946</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2011-09, Vol.6 (9), p.e23946-e23946 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1317878532 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adult AIDS Analysis Anti-HIV Agents - economics Anti-HIV Agents - pharmacology Anti-HIV Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Cohort Studies Cost analysis Cost engineering Cost reduction Cost Savings - statistics & numerical data Costs Data processing Disease control Drug Prescriptions - economics Drug Prescriptions - statistics & numerical data Drug Therapy, Combination - economics Drugs Drugs, Generic - economics Drugs, Generic - pharmacology Drugs, Generic - therapeutic use Economic aspects Female Follow-Up Studies Generic drugs Germany Health care Health services Highly active antiretroviral therapy HIV HIV Infections - drug therapy HIV Reverse Transcriptase - antagonists & inhibitors Human immunodeficiency virus Humans Male Medical research Medical treatment Medicine Pharmaceuticals Prescription drugs Protease inhibitors Protease Inhibitors - economics Protease Inhibitors - pharmacology Protease Inhibitors - therapeutic use Proteases Resource allocation Reverse Transcriptase Inhibitors - economics Reverse Transcriptase Inhibitors - pharmacology Reverse Transcriptase Inhibitors - therapeutic use Ritonavir Taxation Taxes Therapy |
| title | Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort |
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