PMID- 20144493
OWN - NLM
STAT- MEDLINE
DCOM- 20110328
LR  - 20130524
IS  - 1578-1852 (Electronic)
IS  - 0213-005X (Linking)
VI  - 28
IP  - 9
DP  - 2010 Nov
TI  - Cost-effectiveness analysis of HLA-B*5701 typing in the prevention of 
      hypersensitivity to abacavir in HIV+ patients in Spain.
PG  - 590-5
LID - 10.1016/j.eimc.2009.09.010 [doi]
AB  - INTRODUCTION: Approximately 4% to 8% of patients with HIV-1 treated with abacavir 
      present a hypersensitivity reaction (HSR). Various studies have shown a direct 
      association between human leukocyte antigen (HLA)-B*5701 and HSR to abacavir. The 
      objective of this study was to analyze whether systematic HLA-B*5701 testing to 
      prevent HSR in patients treated with abacavir is a cost-effective option for the 
      Spanish National Health System. METHODS: An analytical decision-making model was 
      constructed as a decision tree model for a simulated cohort of 1000 HIV patients 
      to evaluate whether HLA-B*5701 testing to prevent HSR to abacavir was cost 
      effective compared with not performing the test. The parameters included in the 
      model and the use of healthcare resources should the patient develop HSR were 
      taken from the PREDICT-1 study and the opinion of clinical experts. The principal 
      result obtained was the incremental cost per HSR avoided. The time horizon of the 
      analysis was to 2 months [corrected] . All costs were expressed in 2008 Euros. 
      RESULTS: The analysis showed that the total direct healthcare costs per patient 
      were euro1344 and euro1322 with and without HLA-B*5701 testing respectively, and that 
      36 cases of HSR were prevented per 1000 screened patients. These results yielded 
      a cost per HSR avoided of euro630. The sensitivity analysis showed that the results 
      were sensitive to the cost of the test, with an economic saving of euro102 or a 
      cost-effectiveness ratio of euro4234. CONCLUSIONS: The model predicts that 
      generalized use of the HLA-B*5701 test before prescribing abacavir in HIV+ 
      patients could represent an economic saving or a limited additional cost for the 
      National Health System which may be counterbalanced by the benefits in terms of a 
      lower incidence of HSR.
CI  - Copyright (c) 2009 Elsevier Espana, S.L. All rights reserved.
FAU - Nieves Calatrava, Diana
AU  - Nieves Calatrava D
AD  - Oblikue Consulting, Barcelona, Spain. diana.nieves@oblikue.com
FAU - Calle-Martin, Oscar de la
AU  - Calle-Martin Ode L
FAU - Iribarren-Loyarte, Jose A
AU  - Iribarren-Loyarte JA
FAU - Rivero-Roman, Antonio
AU  - Rivero-Roman A
FAU - Garcia-Bujalance, Laura
AU  - Garcia-Bujalance L
FAU - Perez-Escolano, Isabel
AU  - Perez-Escolano I
FAU - Brosa-Riestra, Max
AU  - Brosa-Riestra M
LA  - eng
PT  - Journal Article
DEP - 20100209
PL  - Spain
TA  - Enferm Infecc Microbiol Clin
JT  - Enfermedades infecciosas y microbiologia clinica
JID - 9104081
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Dideoxynucleosides)
RN  - 0 (HLA-B Antigens)
RN  - WR2TIP26VS (abacavir)
SB  - IM
EIN - Enferm Infecc Microbiol Clin. 2012 Jun;30(6):356
MH  - Anti-HIV Agents/*adverse effects
MH  - Cost-Benefit Analysis
MH  - Dideoxynucleosides/*adverse effects
MH  - Drug Hypersensitivity/*economics/immunology/*prevention & control
MH  - HIV Seropositivity/*drug therapy
MH  - *HLA-B Antigens/immunology
MH  - Humans
MH  - Models, Economic
MH  - Spain
EDAT- 2010/02/11 06:00
MHDA- 2011/03/29 06:00
CRDT- 2010/02/11 06:00
PHST- 2009/04/30 00:00 [received]
PHST- 2009/09/15 00:00 [revised]
PHST- 2009/09/29 00:00 [accepted]
PHST- 2010/02/11 06:00 [entrez]
PHST- 2010/02/11 06:00 [pubmed]
PHST- 2011/03/29 06:00 [medline]
AID - S0213-005X(10)00008-X [pii]
AID - 10.1016/j.eimc.2009.09.010 [doi]
PST - ppublish
SO  - Enferm Infecc Microbiol Clin. 2010 Nov;28(9):590-5. doi: 
      10.1016/j.eimc.2009.09.010. Epub 2010 Feb 9.