2022
Cost-Effectiveness of Long-Acting Injectable HIV Preexposure Prophylaxis in the United States : A Cost-Effectiveness Analysis.
Neilan AM, Landovitz RJ, Le MH, Grinsztejn B, Freedberg KA, McCauley M, Wattananimitgul N, Cohen MS, Ciaranello AL, Clement ME, Reddy KP, Hyle EP, Paltiel AD, Walensky RP. Cost-Effectiveness of Long-Acting Injectable HIV Preexposure Prophylaxis in the United States : A Cost-Effectiveness Analysis. Annals Of Internal Medicine 2022, 175: 479-489. PMID: 35099992, PMCID: PMC9087297, DOI: 10.7326/m21-1548.Peer-Reviewed Original ResearchConceptsCAB-LAHIV preexposure prophylaxisCost-effectiveness analysisPreexposure prophylaxisHigh riskNational InstituteIncremental cost-effectiveness ratioCost-effectiveness ratioBase-case analysisHealth care systemEunice KennedyInjectable cabotegravirPrEP retentionOral PrEPHIV PrEPHIV incidenceBlood InstituteDisoproxil fumarateNational HeartChild healthSide effectsTransgender womenInfectious diseasesPrEPQALY
2020
Comparative Pricing of Branded Tenofovir Alafenamide-Emtricitabine Relative to Generic Tenofovir Disoproxil Fumarate-Emtricitabine for HIV Preexposure Prophylaxis: A Cost-Effectiveness Analysis.
Walensky RP, Horn T, McCann NC, Freedberg KA, Paltiel AD. Comparative Pricing of Branded Tenofovir Alafenamide-Emtricitabine Relative to Generic Tenofovir Disoproxil Fumarate-Emtricitabine for HIV Preexposure Prophylaxis: A Cost-Effectiveness Analysis. Annals Of Internal Medicine 2020, 172: 583-590. PMID: 32150602, PMCID: PMC7217721, DOI: 10.7326/m19-3478.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioCost-effectiveness analysisFair priceCost-effectiveness ratioBase-case analysisJustifiable priceSocietal willingnessComparative pricingHealth care sectorPricesTime horizonEnd-stage renal diseaseCases of ESRDQALYDemand PrEPCare sectorEconomic savingsHIV preexposure prophylaxisSensitivity analysisCostPreexposure prophylaxisLife effectsHorizonPricingDiscountHas Pre-exposure Prophylaxis Made a Difference at a Population Level? Jury Is Still Out
Marcus JL, Paltiel AD, Walensky RP. Has Pre-exposure Prophylaxis Made a Difference at a Population Level? Jury Is Still Out. Clinical Infectious Diseases 2020, 71: 3152-3153. PMID: 32097454, PMCID: PMC7819505, DOI: 10.1093/cid/ciz1236.Peer-Reviewed Original Research
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 budgetCD4CareOutcomesThe Cost-effectiveness of Human Immunodeficiency Virus (HIV) Preexposure Prophylaxis and HIV Testing Strategies in High-risk Groups in India
Kazemian P, Costantini S, Kumarasamy N, Paltiel AD, Mayer KH, Chandhiok N, Walensky RP, Freedberg KA. The Cost-effectiveness of Human Immunodeficiency Virus (HIV) Preexposure Prophylaxis and HIV Testing Strategies in High-risk Groups in India. Clinical Infectious Diseases 2019, 70: 633-642. PMID: 30921454, PMCID: PMC7319272, DOI: 10.1093/cid/ciz249.Peer-Reviewed Original ResearchConceptsHIV testing strategiesPreexposure prophylaxisHIV incidenceCost-effective HIV prevention strategyHuman immunodeficiency virus (HIV) preexposure prophylaxisHuman immunodeficiency virus (HIV) epidemicQuarterly HIV testingHigh HIV incidenceHigh-risk groupHIV prevention strategiesIndia-specific dataWorld Health OrganizationIndian MSMRoutine HIVHIV testHIV testingTesting strategiesPWIDPrevention strategiesHIVMean incidenceGross domestic productPrEPMSMHealth Organization
2018
The cost‐effectiveness of HIV pre‐exposure prophylaxis in men who have sex with men and transgender women at high risk of HIV infection in Brazil
Luz PM, Osher B, Grinsztejn B, Maclean RL, Losina E, Stern ME, Struchiner CJ, Parker RA, Freedberg KA, Mesquita F, Walensky RP, Veloso VG, Paltiel AD. The cost‐effectiveness of HIV pre‐exposure prophylaxis in men who have sex with men and transgender women at high risk of HIV infection in Brazil. Journal Of The International AIDS Society 2018, 21: e25096. PMID: 29603888, PMCID: PMC5878414, DOI: 10.1002/jia2.25096.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioHIV infectionTransgender womenPrEP effectivenessHigh riskMedical costsPre-exposure prophylaxis programHIV pre-exposure prophylaxisAnnual HIV incidenceUniversal ART accessPre-exposure prophylaxisHIV testing frequencyDirect medical costsHigh-risk MSMLife expectancyHIV infection riskUndiscounted life expectancyCost-effectiveness ratioYears of lifeUnited States dollarsHIV careHIV incidenceMean ageProphylaxis programART access
2017
The Clinical and Economic Impact of Attaining National HIV/AIDS Strategy Treatment Targets in the United States
Borre ED, Hyle EP, Paltiel AD, Neilan AM, Sax PE, Freedberg KA, Weinstein MC, Walensky RP. The Clinical and Economic Impact of Attaining National HIV/AIDS Strategy Treatment Targets in the United States. The Journal Of Infectious Diseases 2017, 216: 798-807. PMID: 29029344, PMCID: PMC5853503, DOI: 10.1093/infdis/jix349.Peer-Reviewed Original ResearchConceptsNational HIV/AIDS StrategyIncremental cost-effectiveness ratioHuman immunodeficiency virusCost-effectiveness ratioUS National HIV/AIDS StrategyHIV/AIDS StrategyAntiretroviral therapy costsSubstantial clinical benefitHigh HIV prevalenceGeneral US populationYears of lifeVirologic suppressionViral suppressionClinical outcomesAdherence interventionsClinical benefitHIV prevalenceHIV transmissionImmunodeficiency virusMSM populationAIDS StrategyTherapy costsTreatment targetsUS populationBlack menDo Less Harm: Evaluating HIV Programmatic Alternatives in Response to Cutbacks in Foreign Aid.
Walensky RP, Borre ED, Bekker LG, Hyle EP, Gonsalves GS, Wood R, Eholié SP, Weinstein MC, Anglaret X, Freedberg KA, Paltiel AD. Do Less Harm: Evaluating HIV Programmatic Alternatives in Response to Cutbacks in Foreign Aid. Annals Of Internal Medicine 2017, 167: 618-629. PMID: 28847013, PMCID: PMC5675810, DOI: 10.7326/m17-1358.Peer-Reviewed Original ResearchConceptsYears of lifeHIV transmissionHIV programsFuture incident casesSecond-line ARTHIV care continuumViral load monitoringAdverse clinical consequencesResource-limited nationsBase-case analysisCurrent standardHIV deathsIncident casesCôte d'IvoireCare continuumART efficacyClinical consequencesHIV detectionLess HarmHIVSocietal perspectiveProductivity costsNational InstituteDeathYearsA 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
The Anticipated Clinical and Economic Effects of 90-90-90 in South Africa.
Walensky RP, Borre ED, Bekker LG, Resch SC, Hyle EP, Wood R, Weinstein MC, Ciaranello AL, Freedberg KA, Paltiel AD. The Anticipated Clinical and Economic Effects of 90-90-90 in South Africa. Annals Of Internal Medicine 2016, 165: 325-33. PMID: 27240120, PMCID: PMC5012932, DOI: 10.7326/m16-0799.Peer-Reviewed Original ResearchConceptsOverall virologic suppressionVirologic suppressionHIV transmissionYears of lifeMaternal orphansTarget strategyHIV/AIDS 90HIV case detectionIncremental cost-effectiveness ratioJoint United Nations ProgrammeHIV transmission ratesSouth African HIVCost of careCost-effectiveness ratioBase-case analysisAIDS 90Incident infectionsAfrican HIVUnited Nations ProgrammeCase detectionHIV detectionTreatment targetsSouth African survey dataRapid treatmentSocietal perspectiveLaboratory 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
Potential Clinical and Economic Value of Long-Acting Preexposure Prophylaxis for South African Women at High-Risk for HIV Infection
Walensky RP, Jacobsen MM, Bekker LG, Parker RA, Wood R, Resch SC, Horstman NK, Freedberg KA, Paltiel AD. Potential Clinical and Economic Value of Long-Acting Preexposure Prophylaxis for South African Women at High-Risk for HIV Infection. The Journal Of Infectious Diseases 2015, 213: 1523-1531. PMID: 26681778, PMCID: PMC4837902, DOI: 10.1093/infdis/jiv523.Peer-Reviewed Original ResearchConceptsStandard prepSouth African womenPreexposure prophylaxisHIV infectionHigh riskHuman immunodeficiency virus (HIV) infectionEffective prevention optionsAfrican womenImmunodeficiency virus infectionCost-saving interventionHIV infection riskYoung South African womenLikely clinical benefitInjectable PrEPPrEP formulationsEligible womenClinical benefitPotential ClinicalVirus infectionOutcome measuresPrEP strategiesProgram costsPrevention optionsSurvival rateGreater adherenceThe Epi-TAF for Tenofovir Disoproxil Fumarate?
Walensky RP, Horn TH, Paltiel AD. The Epi-TAF for Tenofovir Disoproxil Fumarate? Clinical Infectious Diseases 2015, 62: 915-918. PMID: 26658300, DOI: 10.1093/cid/civ1000.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsBone DiseasesCost-Benefit AnalysisHIV InfectionsHumansKidney DiseasesTenofovirUnited StatesConceptsTenofovir disoproxil fumarateAverage wholesale priceDisoproxil fumarateBone mineral density lossHIV treatment regimenTenofovir/lamivudineImproved toxicity profileHuman immunodeficiency virusMineral density lossAntiretroviral therapyRenal injuryTenofovir alafenamideTreatment regimenImmunodeficiency virusEqual efficacyToxicity profileCost-effectiveness methodsDensity lossUS residentsAlafenamideRegimenLamivudineTherapyInjuryFumarateThe 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 ratePrioritizing HIV comparative effectiveness trials based on value of information: generic versus brand-name ART in the US
Pei PP, Weinstein MC, Li XC, Hughes MD, Paltiel AD, Hou T, Parker RA, Gaynes MR, Sax PE, Freedberg KA, Schackman BR, Walensky RP. Prioritizing HIV comparative effectiveness trials based on value of information: generic versus brand-name ART in the US. HIV Research & Clinical Practice 2015, 16: 207-218. PMID: 26651525, PMCID: PMC4718767, DOI: 10.1080/15284336.2015.1123942.Peer-Reviewed Original ResearchConceptsGeneric antiretroviral therapyAntiretroviral therapyProbabilistic sensitivity analysesTreatment changesFirst-line ART regimensMore treatment changesComparative effectiveness trialTwo-arm trialImproved health outcomesTwo-pillART regimensHIV careART failureEffectiveness trialTrial completionRNA suppressionHealth outcomesFuture patientsPatientsCost-effective strategyTrialsRegimenRegimensHIVTherapy
2014
HIV Cure Strategies: How Good Must They Be to Improve on Current Antiretroviral Therapy?
Sax PE, Sypek A, Berkowitz BK, Morris BL, Losina E, Paltiel AD, Kelly KA, Seage GR, Walensky RP, Weinstein MC, Eron J, Freedberg KA. HIV Cure Strategies: How Good Must They Be to Improve on Current Antiretroviral Therapy? PLOS ONE 2014, 9: e113031. PMID: 25397616, PMCID: PMC4232561, DOI: 10.1371/journal.pone.0113031.Peer-Reviewed Original ResearchMisinterpretation of HIV Preexposure Prophylaxis Findings
Paltiel AD, Walensky RP, Freedberg KA. Misinterpretation of HIV Preexposure Prophylaxis Findings. Clinical Infectious Diseases 2014, 59: 139-141. PMID: 24729554, PMCID: PMC4305145, DOI: 10.1093/cid/ciu240.Peer-Reviewed Original Research
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 ratePersonsBenefitsCost-effectiveness of generic antiretroviral therapy--in response.
Walensky RP, Paltiel AD, Schackman BR. Cost-effectiveness of generic antiretroviral therapy--in response. Annals Of Internal Medicine 2013, 158: 776-7. PMID: 23689770, DOI: 10.7326/0003-4819-158-10-201305210-00016.Peer-Reviewed Original Research