Additional file 1: of New Highly Active Antiretroviral drugs and generic drugs for the treatment of HIV infection: a budget impact analysis on the Italian National Health Service (Lombardy Region, Northern Italy)

Patient’s distribution in the second semester of each year of the base case scenario and of the “new and generic drugs” scenario. (DOCX 39 kb

Costs of treatments and adverse events in euro for each Health State.

<p>Costs of treatments and adverse events in euro for each Health State.</p

Incremental cost effectiveness ratio plan, presenting the results of the probabilistic sensitivity analysis of LPV/r vs. ATV+r 2 regimens.

<p>Incremental cost effectiveness ratio plan, presenting the results of the probabilistic sensitivity analysis of LPV/r vs. ATV+r 2 regimens.</p

Incremental cost effectiveness ratio plan, presenting the results of the probabilistic sensitivity analysis of LPV/r vs. ATV+r 1 regimens.

<p>Incremental cost effectiveness ratio plan, presenting the results of the probabilistic sensitivity analysis of LPV/r vs. ATV+r 1 regimens.</p

Parameters used within the sensitivity analysis performed.

<p>CHD: Coronary heart disease; CKD: Chronic kidney disease; OI: Opportunistic infection; TC: Total cholesterol; HDL: High-density lipoprotein; HS: Health state; QALY: Quality-adjusted life years.</p>*<p>Ranges are: minimum and maximum or percentage variation of base-case values for uniform distributions; mean and standard deviation for normal distributions; alpha and beta are shape parameters for beta distributions.</p>‡<p>Risk values of diarrhoea, hyperbilirubinemia and opportunistic infections distributed according to a beta probability distribution.</p

Lifetime results of the model divided per treatment.

<p>QALY: Quality-adjusted life years; CHD: Coronary heart disease; CKD: Chronic kidney disease; OI: Opportunistic infection; AE: Adverse event; VL: Viral load.</p

QALY variables related to HS, and events entered in the microsimulation model.

<p>HS: Health state; QALY: Quality-adjusted life years; CHD: Coronary heart disease; CKD: Chronic kidney disease; OI Opportunistic infection</p

Structure of the microsimulation model at the individual level.

<p>Circle: event that does not determine a change of line of treatment. Rhombus: event that determine a change of line of treatment. HS: Health State. CHD: Coronary heart disease. CKD: Chronic kidney disease. OI: Opportunistic infection. VL: Viral load. § event that may lead to death. * Detectable viral load for two consecutive semesters. Patients enter the model being in first-line treatment (LPV/r or ATV+r). After each cycle, patients may change health state, die or experience events that may lead to a change in the line of treatment (patients in second-line had different treatment options that excluded those on first-line). Diarrhoea and hyperbilirubinemia may be experienced only by patients in first-line treatment, since these adverse events are associated with LPV/r and ATV+r therapies.</p

Base-case estimates used within the model

<p>SD: standard deviation; DM: diabetes mellitus; CHD: Coronary heart disease; TC: Total cholesterol; HDL: High-density lipoprotein; VL: Viral load; HS: Health state; OI: Opportunistic infection; CKD: Chronic kidney disease</p>*<p>Estimates gathered from the literature and expressed as incidence rates (i.e., event/person-years) were converted into semestral probabilities using standard formulas</p>†<p>Transition probabilities of transitioning to a state with greater viral load (≥ 50 copies/mL) are 19% lesser than LPV/r</p>‡<p>Effect on TC:HDL ratio is considered null in second-line treatment</p