2018
The cost‐effectiveness and budgetary impact of a dolutegravir‐based regimen as first‐line treatment of HIV infection in India
Zheng A, Kumarasamy N, Huang M, Paltiel AD, Mayer KH, Rewari BB, Walensky RP, Freedberg KA. The cost‐effectiveness and budgetary impact of a dolutegravir‐based regimen as first‐line treatment of HIV infection in India. Journal Of The International AIDS Society 2018, 21: e25085. PMID: 29603882, PMCID: PMC5878415, DOI: 10.1002/jia2.25085.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioStandard of careAntiretroviral therapyTenofovir disoproxil fumarateHIV infectionRecent guidelinesFirst-line antiretroviral therapyFirst-line HIV treatmentLifetime incremental cost-effectiveness ratioART-naive patientsDolutegravir-based regimenDTG-based regimenFirst-line treatmentClinical trial dataCost-effectiveness ratioLifetime care costsInitial therapyVirologic suppressionCD4 countHIV diseaseRegimen costsDisoproxil fumarateHIV treatmentAIDS complicationsCare costs
2016
Impact of Cigarette Smoking and Smoking Cessation on Life Expectancy Among People With HIV: A US-Based Modeling Study
Reddy KP, Parker RA, Losina E, Baggett TP, Paltiel AD, Rigotti NA, Weinstein MC, Freedberg KA, Walensky RP. Impact of Cigarette Smoking and Smoking Cessation on Life Expectancy Among People With HIV: A US-Based Modeling Study. The Journal Of Infectious Diseases 2016, 214: 1672-1681. PMID: 27815384, PMCID: PMC5144729, DOI: 10.1093/infdis/jiw430.Peer-Reviewed Original ResearchConceptsSmoking statusSmoking cessationUS smokersLife expectancyT-cell countsHIV treatment programsAge 40 yearsYears of lifeSex-specific dataAntiretroviral therapyInitial CD4Current smokersFormer smokersHIV diseaseHIV infectionCigarette smokingMortality riskSmokersHIVSmoke cigarettesYounger ageTreatment programCessation ageSmokingCessationSurvival 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 ResearchConceptsAntiretroviral 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 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 statusCost-Effectiveness of Genotype Testing for Primary Resistance in Brazil
Luz PM, Morris BL, Grinsztejn B, Freedberg KA, Veloso VG, Walensky RP, Losina E, Nakamura YM, Girouard MP, Sax PE, Struchiner CJ, Paltiel AD. Cost-Effectiveness of Genotype Testing for Primary Resistance in Brazil. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 68: 152-161. PMID: 25415289, PMCID: PMC4294967, DOI: 10.1097/qai.0000000000000426.Peer-Reviewed Original ResearchConceptsGenotype resistance testingART initiationAntiretroviral treatmentART costsGenotype testingEvandro Chagas Clinical Research InstituteResistance prevalenceFirst-line ART initiationHIV Clinical CohortHIV treatment guidelinesIncremental cost-effectiveness ratioBaseline patient characteristicsEffective antiretroviral treatmentART-naive individualsLife expectancyClinical Research InstituteCost-effectiveness ratioImmune recoveryCD4 countViral suppressionHIV diseasePatient characteristicsTreatment guidelinesMean agePrimary resistance
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 therapy
2007
The Effect of Antiretroviral Therapy on Secondary Transmission of HIV among Men Who Have Sex with Men
McCormick AW, Walensky RP, Lipsitch M, Losina E, Hsu H, Weinstein MC, Paltiel AD, Freedberg KA, Seage GR. The Effect of Antiretroviral Therapy on Secondary Transmission of HIV among Men Who Have Sex with Men. Clinical Infectious Diseases 2007, 44: 1115-1122. PMID: 17366461, PMCID: PMC2365722, DOI: 10.1086/512816.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyCohort of individualsHuman immunodeficiency virus RNA loadEffect of ARTImpact of ARTFurther HIV transmissionUnprotected insertive anal intercourseHIV RNA levelsVirus RNA loadCohort of menSecondary transmissionYears of infectionInsertive anal intercourseRisk reduction interventionsHIV diseaseHIV infectionUntreated cohortHIV transmissionRNA loadVirologic courseSecondary casesAnal intercourseSecondary infectionHIVEffective HIV
2006
Cost-Effectiveness of an Intervention to Improve Adherence to Antiretroviral Therapy in HIV-Infected Patients
Freedberg KA, Hirschhorn LR, Schackman BR, Wolf LL, Martin LA, Weinstein MC, Goldin S, Paltiel AD, Katz C, Goldie SJ, Losina E. Cost-Effectiveness of an Intervention to Improve Adherence to Antiretroviral Therapy in HIV-Infected Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2006, 43: s113-s118. PMID: 17133193, DOI: 10.1097/01.qai.0000248334.52072.25.Peer-Reviewed Original ResearchConceptsStandard careNursing interventionsClinical trialsLong-term survival benefitIncremental cost-effectiveness ratioCohort of HIVQuality-adjusted life yearsLifetime medical costsCost-effectiveness ratioVirologic suppressionAntiretroviral therapyViral suppressionAntiretroviral medicationsHIV diseaseSurvival benefitClinical outcomesAdherence interventionsAntiretroviral adherenceMedical costsLife yearsModest effectivenessPatientsInterventionAdherenceHIVThe Survival Benefits of AIDS Treatment in the United States
Walensky RP, Paltiel AD, Losina E, Mercincavage LM, Schackman BR, Sax PE, Weinstein MC, Freedberg KA. The Survival Benefits of AIDS Treatment in the United States. The Journal Of Infectious Diseases 2006, 194: 11-19. PMID: 16741877, DOI: 10.1086/505147.Peer-Reviewed Original ResearchConceptsSurvival benefitAntiretroviral therapyPotent combination antiretroviral therapyPneumocystis jiroveci pneumonia prophylaxisHIV disease treatmentImmunodeficiency syndrome careOpportunistic infection prophylaxisTotal survival benefitUntreated HIV diseaseCombination antiretroviral therapyEffective antiretroviral therapyPrevention of motherAbsence of treatmentYears of lifePneumonia prophylaxisChild transmissionInfant infectionAdult patientsHIV diseaseInfection prophylaxisDisease careNew diagnosisAIDS treatmentProphylaxisSurvival increase
2002
Prevention of Human Immunodeficiency Virus—Related Opportunistic Infections in France: A Cost-Effectiveness Analysis
Yazdanpanah Y, Goldie S, Paltiel A, Losina E, Coudeville L, Weinstein M, Gerard Y, Kimmel A, Zhang H, Salamon R, Mouton Y, Freedberg K. Prevention of Human Immunodeficiency Virus—Related Opportunistic Infections in France: A Cost-Effectiveness Analysis. Clinical Infectious Diseases 2002, 36: 86-96. PMID: 12491207, DOI: 10.1086/344902.Peer-Reviewed Original ResearchConceptsCost-effectiveness ratioTMP-SMZAntiretroviral therapyHIV diseaseOpportunistic infectionsHuman immunodeficiency virus (HIV) diseaseMycobacterium avium complex bacteremiaIncremental cost-effectiveness ratioPerson lifetime costsActive antiretroviral therapyEra of HAARTPneumocystis carinii pneumoniaHuman immunodeficiency virusQuality-adjusted life expectancyCost-effectiveness analysisOral ganciclovirCytomegalovirus infectionToxoplasmic encephalitisCarinii pneumoniaImmunodeficiency virusTherapeutic optionsClinical impactFrench patientsProphylaxisInfectionLifetime 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 ResearchConceptsActive 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 count
2001
The 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 effectivenessPreevaluation of Clinical Trial Data: The Case of Preemptive Cytomegalovirus Therapy in Patients with Human Immunodeficiency Virus
Paltiel A, Goldie S, Losina E, Weinstein M, Seage G, Kimmel A, Zhang H, Freedberg K. Preevaluation of Clinical Trial Data: The Case of Preemptive Cytomegalovirus Therapy in Patients with Human Immunodeficiency Virus. Clinical Infectious Diseases 2001, 32: 783-793. PMID: 11229847, DOI: 10.1086/319223.Peer-Reviewed Original ResearchMeSH KeywordsAIDS-Related Opportunistic InfectionsAntiviral AgentsChemopreventionCost-Benefit AnalysisCytomegalovirusCytomegalovirus InfectionsGanciclovirHIV InfectionsHumansModels, BiologicalPolymerase Chain ReactionPredictive Value of TestsQuality-Adjusted Life YearsSensitivity and SpecificityValganciclovirConceptsHuman immunodeficiency virusDuration of survivalPreemptive therapyCMV casesImmunodeficiency virusCMV polymerase chain reactionEnd-stage HIV diseaseUpcoming trialsCMV preemptive therapySalvage antiretroviral therapyCells/microLClinical trial dataCMV prophylaxisAntiretroviral therapyHIV diseaseComplication rateEfficacy assumptionsPolymerase chain reactionDisease progressionClinical uncertaintyDrug effectsPatientsTrial dataTherapyChain reaction
1998
Cost Effectiveness of Prophylaxis for Opportunistic Infections in AIDS
Freedberg K, Paltiel A. Cost Effectiveness of Prophylaxis for Opportunistic Infections in AIDS. PharmacoEconomics 1998, 14: 165-173. PMID: 10186457, DOI: 10.2165/00019053-199814020-00005.Peer-Reviewed Original ResearchConceptsHIV patient careOpportunistic infectionsInfection preventionPatient careImmune system destructionSpecific opportunistic infectionsMajor opportunistic infectionNew antiretroviral therapiesQuality of lifeCost-effectiveness evaluationCost-effectiveness analysisCost effectivenessProphylaxis regimensAntiretroviral therapyHIV diseaseHIV infectionViral loadClinical guidelinesConsiderable financial strainProphylaxisClinical advancesViral replicationEffective agentInfectionHIVThe Cost-Effectiveness of Preventing Cytomegalovirus Disease in AIDS Patients
Paltiel A, Freedberg K. The Cost-Effectiveness of Preventing Cytomegalovirus Disease in AIDS Patients. Interfaces 1998, 28: 34-51. DOI: 10.1287/inte.28.3.34.Peer-Reviewed Original ResearchIncidence of infectionLate-stage HIV diseaseToxicity of therapyNational cohort studyProgression of illnessCost-effectiveness resultsPrice of therapyCMV prophylaxisCytomegalovirus diseaseCytomegalovirus infectionHIV diseaseCohort studyPatients' qualityAIDS patientsClinical trialsNatural historyInfectionProphylaxisTherapyIncidenceDiseaseCompartmental modelPatientsIllnessProgression