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Cost-effectiveness of ganciclovir (DHPG) versus foscarnet (FOS) for cytomegalovirus (CMV) retinitis in patients with AIDS.

Cheung TW, Fahs M, Sacks HS; International Conference on AIDS.

Int Conf AIDS. 1992 Jul 19-24; 8: D517 (abstract no. PoD 5768).

Mount Sinai School of Medicine, New York, NY.

OBJECTIVE: To compare the cost-effectiveness of DHPG versus FOS for the treatment of CMV retinitis in patients with AIDS. METHODS: Patient information was based on the results of the Studies of Ocular Complications of AIDS Research Group in the treatment of CMV retinitis in HIV-infected patients with either DHPG or FOS. Direct costs were based on the treatment protocol; costs included the costs of medication, physician visits, monitoring, home infusion (nursing, i.v. bags and tubings, i.v. pump) and pharmacist compounding the drug. Utility (quality of life) was calculated by indexing patient's morbidity (neutropenia, renal dysfunction and medication switch). RESULTS: The calculated life expectancy for DHPG versus FOS for treatment of CMV retinitis is 1.02 years and 1.52 years respectively. The total cost of providing DHPG and FOS treatment is $39,818.74 and $64,245.00 respectively, while the medication cost for DHPG and FOS is $8,818.74 and $23,520.00 respectively. The utility ratio for DHPG and FOS is 0.76 and 0.70 respectively. However, the cost per year of life saved for DHPG and FOS is similar, i.e., $39,037.98 and $42,266.34 respectively. In adopting FOS instead of DHPG as an initial therapy, the incremental cost-effectiveness ratio is $48,852.00 per life-year gained and the incremental cost-utility ratio is $87,236.64 per quality-adjusted life expectancy gained. CONCLUSION: Treatment of CMV retinitis in HIV patients is costly. Although the total cost of providing FOS is more expensive than DHPG, the cost per year of life saved is similar. While the range is within the present accepted standard medical cost (less than $100,000 per life year service), the ratio can be improved with the reduction of the price of FOS.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Acquired Immunodeficiency Syndrome
  • Cost-Benefit Analysis
  • Cytomegalovirus Retinitis
  • Disease Progression
  • Foscarnet
  • Ganciclovir
  • Genes, fos
  • HIV Infections
  • HIV Seropositivity
  • Humans
  • Life Expectancy
  • Methoxyhydroxyphenylglycol
  • Retinitis
  • dihydroxyphenylethylene glycol
  • economics
  • genetics
Other ID:
  • 92403233
UI: 102200947

From Meeting Abstracts




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