Abstract
BACKGROUND: Today we assist to a shift of the paradigm of the treatment of HIV positive subjects, from the use of triple therapies to dual therapies. The objective of the analysis is to assess the economic sustainability of the use of a fix dose of dolutegravir / rilpivirina (DTG/RPV) in the Italian national context, through the implementation of a budget impact analysis, considering also the assessment at a regional level. METHODS: The analysis conducted is based on a budget impact model with a three-year time horizon (2020-2022), assuming the perspective of the Italian National Health Service and of Regional Health Services. The costs considered in the analysis are direct medical costs related to the antiretroviral therapies, in a scenario that does not consider the use of DTG/RPV and in a scenario that considers its use. RESULTS: The use of DTG/RPV would lead to a reduction of antiretroviral treatment cost of – 6,626,121 € in 2020 (–3.7%), – 7,594,681 € in 2021 (–4.2%) and – 8,524,315 € in 2022 (–4.7%), with a three years cumulative result of– 22,745,117 € (–4.2%). At a regional level, the minor costs assessed due to the use of DTG/RPV are variable, based on the number of patients treated, related with the total population, with the incidence and prevalence of the pathology and with the yearly population changes. The higher costs reduction in the three years considered would be assessed in Lombardy (-6.0 million €), in Lazio (-3.0 million €), in Emilia- Romagna (-2.2 million €), in Veneto (-1.7 million €) and in Tuscany (-1.3 million €). CONCLUSIONS: The results of the analysis are in line with already published international health economics analyses, showing the sustainability of the use of DTG/ RPV in the Italian context and in regional health contexts between 2020-2022.