Cost-effectiveness of atazanavir-ritonavir versus lopinavir-ritonavir in HIV patients initiating first-line antiretroviral therapy

Methods A Markov microsimulation model was developed to project lifetime health-related outcomes, costs, qualityadjusted life years (QALYs), and cost-effectiveness of ATV/r versus LPV/r, both with tenofovir-emtricitabine, as first-line ART. Virologic suppression, baseline characteristics, state transition probabilities, cholesterol changes, and adverse effects were based on 96-week CASTLE results. HIV-related mortality, opportunistic infection (OI) and AIDS rates, coronary heart disease (CHD) risk, treatment adherence, costs, and utilities were obtained from published sources. Costs were reported in 2009 US dollars. Sensitivity analyses were conducted to assess the robustness of study results.