Seemingly Unrelated Regression Analysis of the Cost and Health-Related Quality of Life Outcomes of the REVAMP Randomized Clinical Trial.

Humans Anti-HIV Agents / therapeutic use Quality of Life South Africa
cost-effectiveness health economics resistance testing seemingly unrelated regression virological failure

Journal

Value in health regional issues
ISSN: 2212-1102
Titre abrégé: Value Health Reg Issues
Pays: United States
ID NLM: 101592642

Informations de publication

Date de publication:
May 2023
Historique:
received: 22 09 2022
revised: 29 11 2022
accepted: 17 12 2022
pmc-release: 01 05 2024
medline: 8 5 2023
pubmed: 3 3 2023
entrez: 2 3 2023
Statut: ppublish

Résumé

This study aimed to evaluate the 9-month cost and health-related quality of life (HRQOL) outcomes of resistance versus viral load testing strategies to manage virological failure in low-middle income countries. We analyzed secondary outcomes from the REVAMP clinical trial: a pragmatic, open label, parallel-arm randomized trial investigating resistance versus viral load testing for individuals failing first-line treatment in South Africa and Uganda. We collected resource data, valued according to local cost data and used the 3-level version of EQ-5D to measure HRQOL at baseline and 9 months. We applied seemingly unrelated regression equations to account for the correlation between cost and HRQOL. We conducted intention-to-treat analyses with multiple imputation using chained equations for missing data and performed sensitivity analyses using complete cases. For South Africa, resistance testing and opportunistic infections were associated with statistically significantly higher total costs, and virological suppression was associated with lower total cost. Higher baseline utility, higher cluster of differentiation 4 (CD4) count, and virological suppression were associated with better HRQOL. For Uganda, resistance testing and switching to second-line treatment were associated with higher total cost, and higher CD4 was associated with lower total cost. Higher baseline utility, higher CD4 count, and virological suppression were associated with better HRQOL. Sensitivity analyses of the complete-case analysis confirmed the overall results. Resistance testing showed no cost or HRQOL advantage in South Africa or Uganda over the 9-month REVAMP clinical trial.

Identifiants

DOI: 10.1016/j.vhri.2022.12.006 PMID: 36863066 PMC: PMC10256267
pubmed: 36863066
pii: S2212-1099(23)00006-7
doi: 10.1016/j.vhri.2022.12.006
pmc: PMC10256267
mid: NIHMS1880592
pii:
doi:

Substances chimiques

Anti-HIV Agents 0

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

42-47

Subventions

Organisme : NIAID NIH HHS
ID : R01 AI124718
Pays : United States

Informations de copyright

Copyright © 2023 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.

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Auteurs

Tamlyn A Rautenberg (TA)

Centre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Allied Health Services, Metro North Hospital and Health Service, Brisbane, QLD, Australia. Electronic address: t.rautenberg@griffith.edu.au.

Shu Kay Ng (SK)

Centre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia.

Gavin George (G)

Health Economics and HIV Research Division, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; Division of Social Medicine and Global Health, Lund University, Lund, Sweden.

Mahomed-Yunus S Moosa (MS)

School of Clinical Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.

Suzanne M McCluskey (SM)

Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.

Rebecca F Gilbert (RF)

Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.

Selvan Pillay (S)

School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.

Isaac Aturinda (I)

Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.

Kevin L Ard (KL)

Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.

Winnie Muyindike (W)

Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.

Nicholas Musinguzi (N)

Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.

Godfrey Masette (G)

Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.

Melendhran Pillay (M)

Department of Virology, National Health Laboratory Service, Durban, South Africa.

Pravi Moodley (P)

Department of Virology, National Health Laboratory Service, Durban, South Africa; Department of Virology, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.

Jaysingh Brijkumar (J)

Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.

Rajesh T Gandhi (RT)

Department of Medicine, Harvard Medical School, Boston, MA, USA.

Brent Johnson (B)

Department of Biostatistics and Computation Biology, University of Rochester, Rochester, NY, USA.

Henry Sunpath (H)

Department of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.

Mwebesa B Bwana (MB)

Mbarara University of Science and Technology, Mbarara, Uganda.

Vincent C Marconi (VC)

Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA.

Mark J Siedner (MJ)

Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Department of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; Africa Health Research Institute, KwaZulu-Natal, South Africa.

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