Long-term clinical effectiveness and cost-effectiveness of 10 first-line antiretroviral therapy regimens for HIV-infected patients in China
- VernacularTitle:10种一线抗逆转录病毒治疗方案用于我国HIV感染者的长期有效性与经济性
- Author:
Kejia ZHOU
1
;
Dachuang ZHOU
1
;
Wenxi TANG
1
Author Information
1. School of International Pharmaceutical Business，China Pharmaceutical University，Nanjing 211198，China
- Publication Type:Journal Article
- Keywords:
HIV;
antiretroviral therapy;
AIDS;
integrase inhibitors;
non-nucleoside reverse transcriptase inhibitors
- From:
China Pharmacy
2026;37(10):1295-1301
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the long-term clinical effectiveness and cost-effectiveness of 10 commonly used first-line antiretroviral therapy （ART） regimens for HIV-infected patients in China. METHODS PubMed， CNKI， and other databases were searched to collect meta-analyses of ART regimens published between 2015 and 2025， and short-term efficacy data were synthesized. A Markov model was constructed to simulate disease progression in HIV-infected patients and to extrapolate the long-term clinical and economic outcomes of different ART regimens. From the perspective of the healthcare system， life years， total costs， quality-adjusted life years （QALYs）， and incremental cost-effectiveness ratio （ICER） were estimated. Sensitivity analyses were conducted to assess the robustness of the results. RESULTS One network meta-analysis was ultimately included. Long-term extrapolation showed that integrase inhibitor （INSTI） regimens achieved the best clinical outcomes. Compared with efavirenz （EFV）， dolutegravir （DTG） ，raltegravir （RAL） and elvitegravir/cobicistat （EVG/c） increased per-capita life expectancy by 4.47，2.90 and 2.15 years， respectively. The top five regimens in terms of cost-effectiveness were low-dose EFV， DTG， RAL， EVG/c， and rilpivirine （RPV） with ICERs of 4 414.45， 10 618.31， 21 577.71， 24 003.88， and 32 166.84 yuan/QALY compared to the EFV regimen， respectively. CONCLUSIONS Compared with EFV regimen， INSTI regimens （DTG， RAL and EVG/c） demonstrate superior efficacy as first-line ART regimens for HIV-infected patients in China. Low-dose EFV，RPV and these three INSTI regimens show substantial cost-effectiveness advantages.
