2020
Cost-effectiveness of Frequent HIV Screening Among High-risk Young Men Who Have Sex With Men in the United States
Neilan AM, Bulteel AJB, Hosek SG, Foote JHA, Freedberg KA, Landovitz RJ, Walensky RP, Resch SC, Kazemian P, Paltiel AD, Weinstein MC, Wilson CM, Ciaranello AL. Cost-effectiveness of Frequent HIV Screening Among High-risk Young Men Who Have Sex With Men in the United States. Clinical Infectious Diseases 2020, 73: e1927-e1935. PMID: 32730625, PMCID: PMC8492162, DOI: 10.1093/cid/ciaa1061.Peer-Reviewed Original ResearchConceptsQuality-adjusted life expectancyHIV transmissionAge 15High-risk young menAdolescent Medicine Trials NetworkAntiretroviral therapy initiationIncremental cost-effectiveness ratioNew HIV infectionsLife expectancyYoung menCost-effectiveness ratioFrequent HIVCD4 countHIV screeningTherapy initiationHIV infectionClinical outcomesHIV incidenceClinical benefitFrequent screeningART costsHIVAge 30Trials NetworkYMSM
2019
Cost-effectiveness and budget impact of immediate antiretroviral therapy initiation for treatment of HIV infection in Côte d’Ivoire: A model-based analysis
Ouattara EN, MacLean RL, Danel C, Borre ED, Gabillard D, Huang M, Moh R, Paltiel AD, Eholié SP, Walensky RP, Anglaret X, Freedberg KA. Cost-effectiveness and budget impact of immediate antiretroviral therapy initiation for treatment of HIV infection in Côte d’Ivoire: A model-based analysis. PLOS ONE 2019, 14: e0219068. PMID: 31247009, PMCID: PMC6597104, DOI: 10.1371/journal.pone.0219068.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioImmediate ARTImmediate ART initiationART initiationBudget impactLife expectancyImmediate antiretroviral therapy initiationDecrease HIV transmissionLate ART initiationModest budget impactAntiretroviral therapy initiationMedical resource useCost-effectiveness ratioCost-effectiveness analysisTherapy initiationHIV infectionHIV transmissionCôte d'IvoireART costsART efficacySTART trialCare budgetCD4CareOutcomes
2017
A Flow-Based Model of the HIV Care Continuum in the United States
Gonsalves GS, Paltiel AD, Cleary PD, Gill MJ, Kitahata MM, Rebeiro PF, Silverberg MJ, Horberg M, Abraham AG, Althoff KN, Moore R, Bosch RJ, Tang T, Hall HI, Kaplan EH. A Flow-Based Model of the HIV Care Continuum in the United States. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2017, 75: 548-553. PMID: 28471841, PMCID: PMC5533168, DOI: 10.1097/qai.0000000000001429.Peer-Reviewed Original ResearchConceptsViral suppressionAntiretroviral therapyHIV careNorth American AIDS Cohort CollaborationProportion of HIVHIV care continuumCohort CollaborationHIV diagnosisAntiretroviral treatmentVirological dataCare continuumFlow of patientsDisease controlPatientsCareAverage timeHIVTherapyLaboratory resultsMonthsSuppressionYearsDiagnosisIndividualsPrevention
2016
Laboratory Monitoring of Antiretroviral Therapy for HIV Infection: Cost-Effectiveness and Budget Impact of Current and Novel Strategies
Ouattara EN, Robine M, Eholié SP, MacLean RL, Moh R, Losina E, Gabillard D, Paltiel AD, Danel C, Walensky RP, Anglaret X, Freedberg KA. Laboratory Monitoring of Antiretroviral Therapy for HIV Infection: Cost-Effectiveness and Budget Impact of Current and Novel Strategies. Clinical Infectious Diseases 2016, 62: 1454-1462. PMID: 26936666, PMCID: PMC4872286, DOI: 10.1093/cid/ciw117.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioAntiretroviral therapyHuman immunodeficiency virusImmunologic failureLaboratory monitoringAIDS Complications-International modelFirst-line antiretroviral therapyBudget impactSecond-line antiretroviral therapyMean CD4 countStandard of careCost-effectiveness ratioLaboratory test costsCD4 monitoringART initiationCD4 countHIV infectionVL monitoringClinical outcomesImmunodeficiency virusCôte d'IvoireMean timeLife expectancyTherapyVL strategiesSurvival benefits of antiretroviral therapy in Brazil: a model‐based analysis
Luz PM, Girouard MP, Grinsztejn B, Freedberg KA, Veloso VG, Losina E, Struchiner CJ, MacLean RL, Parker RA, Paltiel AD, Walensky RP. Survival benefits of antiretroviral therapy in Brazil: a model‐based analysis. Journal Of The International AIDS Society 2016, 19: 20623. PMID: 27029828, PMCID: PMC4814587, DOI: 10.7448/ias.19.1.20623.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-HIV AgentsBrazilCD4 Lymphocyte CountHIV InfectionsHumansLife ExpectancyModels, TheoreticalConceptsAntiretroviral therapyHIV-positive patientsSurvival benefitART initiationEligible HIV-positive patientsProvision of ARTDramatic survival benefitsSubsequent ART regimensMean CD4 countLife expectancyNumber of patientsProjected life expectancyART regimensCD4 countHigher CD4HIV diseaseRegimen efficacyLife expectancy increasesEra 1PatientsTherapyNational programExpectancyCD4Regimens
2015
The Cost-effectiveness and Budget Impact of 2-Drug Dolutegravir-Lamivudine Regimens for the Treatment of HIV Infection in the United States
Girouard MP, Sax PE, Parker RA, Taiwo B, Freedberg KA, Gulick RM, Weinstein MC, Paltiel AD, Walensky RP. The Cost-effectiveness and Budget Impact of 2-Drug Dolutegravir-Lamivudine Regimens for the Treatment of HIV Infection in the United States. Clinical Infectious Diseases 2015, 62: 784-791. PMID: 26658053, PMCID: PMC4772845, DOI: 10.1093/cid/civ981.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioStandard of careVirologic suppressionART costsBudget impactHuman immunodeficiency virus (HIV) treatmentART-naive patientsDTG/ABC/3TCVirologic suppression ratesSubsequent virologic failureCost-effectiveness ratioPerson/yearInitial regimenAntiretroviral therapyInduction regimenNaive patientsVirologic failureAntiretroviral agentsDual therapyHIV infectionTwo-drugDolutegravirVirus treatmentRegimenSurvival rateThe Lifetime Medical Cost Savings From Preventing HIV in the United States
Schackman BR, Fleishman JA, Su AE, Berkowitz BK, Moore RD, Walensky RP, Becker JE, Voss C, Paltiel AD, Weinstein MC, Freedberg KA, Gebo KA, Losina E. The Lifetime Medical Cost Savings From Preventing HIV in the United States. Medical Care 2015, 53: 293-301. PMID: 25710311, PMCID: PMC4359630, DOI: 10.1097/mlr.0000000000000308.Peer-Reviewed Original ResearchConceptsHIV infectionLifetime medical costsMedical costsUS health system perspectiveAntiretroviral treatment statusHIV disease treatmentHIV Research NetworkTransmission risk groupsCD4 cell countHigh-risk individualsHealth system perspectiveHIV prevention interventionsMedical cost savingsMedical Expenditure Panel SurveyLifetime cost estimatesRace/ethnicityPreexposure prophylaxisHIV diseaseHIV preventionRisk groupsPrevention interventionsAge 35High riskSecondary infectionTreatment status
2014
The Clinical and Economic Impact of Point-of-Care CD4 Testing in Mozambique and Other Resource-Limited Settings: A Cost-Effectiveness Analysis
Hyle EP, Jani IV, Lehe J, Su AE, Wood R, Quevedo J, Losina E, Bassett IV, Pei PP, Paltiel AD, Resch S, Freedberg KA, Peter T, Walensky RP. The Clinical and Economic Impact of Point-of-Care CD4 Testing in Mozambique and Other Resource-Limited Settings: A Cost-Effectiveness Analysis. PLOS Medicine 2014, 11: e1001725. PMID: 25225800, PMCID: PMC4165752, DOI: 10.1371/journal.pmed.1001725.Peer-Reviewed Original ResearchConceptsCare CD4 testIncremental cost-effectiveness ratioCare CD4 testingPOC CD4CD4 testCD4 testingResource-limited settingsHIV diagnosisHIV testingClinical outcomesAntiretroviral therapy (ART) eligibilityPerson lifetime costsLife expectancyLifetime costsCost-effectiveness ratioResource limited settingsCost-effectiveness analysisSensitivity/specificityImmunological stagingLow sensitivity/specificityCost-effective thresholdLaboratory-based testsSurvivalEditors' SummaryOutcomesMobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness
Bassett IV, Govindasamy D, Erlwanger AS, Hyle EP, Kranzer K, van Schaik N, Noubary F, Paltiel AD, Wood R, Walensky RP, Losina E, Bekker LG, Freedberg KA. Mobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness. PLOS ONE 2014, 9: e85197. PMID: 24465503, PMCID: PMC3898963, DOI: 10.1371/journal.pone.0085197.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioFacility-based testingHIV screeningHIV diagnosisFacility-based HIV testingFrequency of HIVUndiagnosed HIV prevalenceEarly HIV diagnosisLife expectancyMobile screening unitCost-effectiveness ratioResource-limited settingsCD4 countUndiagnosed HIVHIV testingHIV prevalenceCape TownClinical impactPopulation life expectancyMedical costsHIVScreening unitIntervention costsDiagnosisMedical facilities
2013
The Survival Benefits of Antiretroviral Therapy in South Africa
April MD, Wood R, Berkowitz BK, Paltiel AD, Anglaret X, Losina E, Freedberg KA, Walensky RP. The Survival Benefits of Antiretroviral Therapy in South Africa. The Journal Of Infectious Diseases 2013, 209: 491-499. PMID: 24307741, PMCID: PMC3903379, DOI: 10.1093/infdis/jit584.Peer-Reviewed Original ResearchConceptsSecond-line antiretroviral therapyAntiretroviral therapySurvival benefitAIDS Complications-International modelTotal survival benefitT-cell countsHuman immunodeficiency virusART initiationART rolloutUntreated patientsImmunodeficiency virusART availabilitySurvival differencesSuppressive efficacyCohortPatientsTherapyTotal numberRetention ratePersonsBenefits
2012
Newer drugs and earlier treatment
Sloan CE, Champenois K, Choisy P, Losina E, Walensky RP, Schackman BR, Ajana F, Melliez H, Paltiel AD, Freedberg KA, Yazdanpanah Y. Newer drugs and earlier treatment. AIDS 2012, 26: 45-56. PMID: 22008655, PMCID: PMC3237010, DOI: 10.1097/qad.0b013e32834dce6e.Peer-Reviewed Original ResearchConceptsCD4 cell countAntiretroviral therapyHIV RNACD4 cellsHIV diseaseCells/Life expectancyCell countMean CD4 cell countMean age 38 yearsAge 38 yearsMedical resource utilizationLifetime costsUndiscounted life expectancyCost of careAIDS Complications (CEPAC) modelART initiationHIV CostRegimen costsAntiretroviral drugsART costsEarly treatmentCopies/High-income countriesEfficacious drugs
2009
When to start antiretroviral therapy in resource-limited settings.
Walensky RP, Wolf LL, Wood R, Fofana MO, Freedberg KA, Martinson NA, Paltiel AD, Anglaret X, Weinstein MC, Losina E. When to start antiretroviral therapy in resource-limited settings. Annals Of Internal Medicine 2009, 151: 157-66. PMID: 19620143, PMCID: PMC3092478, DOI: 10.7326/0003-4819-151-3-200908040-00138.Peer-Reviewed Original ResearchMeSH KeywordsAdultAIDS-Related Opportunistic InfectionsAnti-HIV AgentsAnti-Infective AgentsCD4 Lymphocyte CountCohort StudiesComputer SimulationCost-Benefit AnalysisDecision TreesDisease ProgressionDrug Administration ScheduleHealth Care CostsHIV InfectionsHumansLife ExpectancySensitivity and SpecificitySouth AfricaTrimethoprim, Sulfamethoxazole Drug CombinationConceptsAntiretroviral therapyCD4 countLong-term survivalCells/LART initiationCells/L.ART initiation strategiesIncremental cost-effectiveness ratioSevere opportunistic diseaseDoris Duke Charitable FoundationLife expectancyCD4 count thresholdHIV treatment decisionsCost-effectiveness ratioInternational clinical trialsBase-case analysisResource-limited settingsYears of lifeCost-effectiveness analysisPerson's life expectancyObservational cohortCD4 thresholdHIV diseaseTreatment guidelinesEarly therapyHIV Testing Rates and Outcomes in a South African Community, 2001-2006: Implications for Expanded Screening Policies
April MD, Walensky RP, Chang Y, Pitt J, Freedberg KA, Losina E, Paltiel AD, Wood R. HIV Testing Rates and Outcomes in a South African Community, 2001-2006: Implications for Expanded Screening Policies. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2009, 51: 310-316. PMID: 19582895, PMCID: PMC3209660, DOI: 10.1097/qai.0b013e3181a248e6.Peer-Reviewed Original ResearchConceptsART initiation ratesHIV testing ratesAntiretroviral treatmentTesting ratesHIV testingWorld Health Organization stageProvider-initiated testingFirst-time testersWorld Health Organization recommendationsMonths of eligibilityHigh-prevalence populationsHealth care facilitiesProportion of clientsMedian CD4Testing registersAnnual incidenceHIV servicesLate diagnosisPrevalence populationsTreatment trendsCare facilitiesStage distributionScreening policiesPatient recordsPopulation testing
2005
Cost-Effectiveness of Enfuvirtide in Treatment-Experienced Patients With Advanced HIV Disease
Sax PE, Losina E, Weinstein MC, Paltiel AD, Goldie SJ, Muccio TM, Kimmel AD, Zhang H, Freedberg KA, Walensky RP. Cost-Effectiveness of Enfuvirtide in Treatment-Experienced Patients With Advanced HIV Disease. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2005, 39: 69-77. PMID: 15851916, DOI: 10.1097/01.qai.0000160406.08924.a2.Peer-Reviewed Original ResearchOptimal Frequency of Cd4 Cell Count and HIV Rna Monitoring Prior to Initiation of Antiretroviral Therapy in HIV-Infected Patients
Kimmel AD, Goldie SJ, Walensky RP, Losina E, Weinstein MC, Paltiel AD, Zhang H, Freedberg KA. Optimal Frequency of Cd4 Cell Count and HIV Rna Monitoring Prior to Initiation of Antiretroviral Therapy in HIV-Infected Patients. Antiviral Therapy 2005, 10: 41-52. PMID: 15751762, DOI: 10.1177/135965350501000102.Peer-Reviewed Original ResearchConceptsCD4 cell countQuality-adjusted life yearsHIV RNA monitoringAntiretroviral therapy initiationIncremental CE ratioCell countAntiretroviral therapyTherapy initiationTreatment thresholdCD4 cell count thresholdCD4 cells/mm3Initial clinical presentationCells/mm3Log10 copies/Incremental clinical benefitLife expectancyQuality-adjusted life expectancyHIV simulation modelHypothetical clinical settingsMore frequent monitoringCost-effectiveness analysisCell count thresholdAntiretroviral initiationVirological predictorsHIV RNA
2002
Lifetime Cost of HIV Care in France during the Era of Highly Active Antiretroviral Therapy
Yazdanpanah Y, Goldie SJ, Losina E, Weinstein MC, Lebrun T, Paltiel AD, Seage GR, Leblanc G, Ajana F, Kimmel AD, Zhang H, Salamon R, Mouton Y, Freedberg KA. Lifetime Cost of HIV Care in France during the Era of Highly Active Antiretroviral Therapy. Antiviral Therapy 2002, 7: 257-266. PMID: 12553480, DOI: 10.1177/135965350200700405.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntiretroviral Therapy, Highly ActiveCD4 Lymphocyte CountCohort StudiesFranceHealth Care CostsHIV InfectionsHumansMiddle AgedConceptsActive antiretroviral therapyHIV infectionCD4 strataAntiretroviral therapyHIV careHIV diseaseLifetime costsHighly Active Antiretroviral TherapyHigher CD4 strataHIV Clinical CohortLowest CD4 stratumCD4 cell countEra of HAARTBurden of diseaseStage of illnessCost of careHealth policy plannersHealth care costsClinical managementSpecific AIDSClinical cohortMean costFrench patientsCare costsCell countState AIDS Drug Assistance Programs
Johri M, Paltiel A, Goldie S, Freedberg K. State AIDS Drug Assistance Programs. Medical Care 2002, 40: 429-441. PMID: 11961477, DOI: 10.1097/00005650-200205000-00008.Peer-Reviewed Original ResearchMeSH KeywordsAcquired Immunodeficiency SyndromeAnti-HIV AgentsCD4 Lymphocyte CountCost of IllnessCost-Benefit AnalysisDirect Service CostsDisease ProgressionEfficiency, OrganizationalEligibility DeterminationHealth Services AccessibilityHumansInsurance CoverageInsurance, Pharmaceutical ServicesLife ExpectancyMedical AssistanceModels, EconometricOrganizational InnovationQuality-Adjusted Life YearsState Health PlansUnited StatesConceptsQuality-adjusted life yearsLifetime direct medical costsLife yearsDirect medical costsDrug Assistance ProgramsAssistance programsState-transition simulation modelQuality-adjusted life expectancyADAP programEconomic performanceLife expectancyMedical costsCost-effective useLifetime costsCost dataServices Utilization SurveyState policyAIDS CostState AIDSCoverage variesComprehensive policyUtilization SurveyPolicyCare resourcesPessimistic assumptionsProphylaxis for Human Immunodeficiency Virus–Related Pneumocystis carinii Pneumonia: Using Simulation Modeling to Inform Clinical Guidelines
Goldie SJ, Kaplan JE, Losina E, Weinstein MC, Paltiel AD, Seage GR, Craven DE, Kimmel AD, Zhang H, Cohen CJ, Freedberg KA. Prophylaxis for Human Immunodeficiency Virus–Related Pneumocystis carinii Pneumonia: Using Simulation Modeling to Inform Clinical Guidelines. JAMA Internal Medicine 2002, 162: 921-928. PMID: 11966344, DOI: 10.1001/archinte.162.8.921.Peer-Reviewed Original ResearchMeSH KeywordsAIDS-Related Opportunistic InfectionsAnti-Infective AgentsAntiprotozoal AgentsAtovaquoneCD4 Lymphocyte CountCost-Benefit AnalysisDapsoneDrug CostsHumansLife ExpectancyModels, TheoreticalNaphthoquinonesPentamidinePneumonia, PneumocystisPractice Guidelines as TopicQuality-Adjusted Life YearsConceptsQuality-adjusted life yearsCD4 cell countQuality-adjusted life expectancyPneumocystis carinii pneumoniaCD4 cell count increasePCP prophylaxisCell count increaseCell countCarinii pneumoniaClinical guidelinesCD4 cell count criteriaInitial CD4 cell countCD4 lymphocyte countPrimary PCP prophylaxisActive antiretroviral therapyCohort of HIVHuman immunodeficiency virusTMP/SMXCount increaseAntiretroviral therapyLymphocyte countHIV infectionImmunodeficiency virusTrimethoprim-sulfamethoxazoleProphylaxis
2001
Incidence of primary opportunistic infections in two human immunodeficiency virus-infected French clinical cohorts
Yazdanpanah Y, Chêne G, Losina E, Goldie S, Merchadou L, Alfandari S, Seage G, Sullivan L, Marimoutou C, Paltiel A, Salamon R, Mouton Y, Freedberg K. Incidence of primary opportunistic infections in two human immunodeficiency virus-infected French clinical cohorts. International Journal Of Epidemiology 2001, 30: 864-871. PMID: 11511618, DOI: 10.1093/ije/30.4.864.Peer-Reviewed Original ResearchConceptsPneumocystis carinii pneumoniaPrimary opportunistic infectionCommon opportunistic infectionOpportunistic infectionsCarinii pneumoniaToxoplasmic encephalitisCytomegalovirus infectionIncidence rateGroupe d'Epidémiologie Clinique du SIDAAIDS Reference CenterCD4 lymphocyte declineIncidence of HIVHuman immunodeficiency virusAbsence of prophylaxisHIV risk behaviorsHigh incidence rateHospital-based information systemCandida esophagitisCount declineImmunodeficiency virusLymphocyte declineAntiretroviral drugsClinical guidelinesSpecific infectionsClinical cohortThe Cost Effectiveness of Combination Antiretroviral Therapy for HIV Disease
Freedberg K, Losina E, Weinstein M, Paltiel A, Cohen C, Seage G, Craven D, Zhang H, Kimmel A, Goldie S. The Cost Effectiveness of Combination Antiretroviral Therapy for HIV Disease. New England Journal Of Medicine 2001, 344: 824-831. PMID: 11248160, DOI: 10.1056/nejm200103153441108.Peer-Reviewed Original ResearchMeSH KeywordsAIDS-Related Opportunistic InfectionsAnti-HIV AgentsCD4 Lymphocyte CountComputer SimulationCost-Benefit AnalysisDirect Service CostsDisease ProgressionDrug CostsDrug Therapy, CombinationHealth Care CostsHIV InfectionsHumansLife ExpectancyModels, BiologicalQuality-Adjusted Life YearsRNA, ViralUnited StatesValue of LifeConceptsQuality-adjusted yearThree-drug therapyCombination antiretroviral therapyCD4 cell countQuality of lifeAntiretroviral therapyHIV diseaseClinical benefitDrug costsLife expectancyCell countInitial CD4 cell countThree-drug antiretroviral regimensHuman immunodeficiency virus (HIV) infectionHIV RNA levelsPerson lifetime costsImmunodeficiency virus infectionMajor clinical trialsDirect medical costsStandard of careProgression of diseaseLifetime direct medical costsCost-effectiveness ratioServices Utilization SurveyCost effectiveness